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Review of PCS Billing

Review of PCS Billing. NC Division of Medical Assistance February 2013. NCECSWeb Tool. Next slides will present Screen Shots of actual form on Web Tool Web Tool https://webclaims.ncmedicaid.com/ncecs Must have a HPES login and password Don’t have a login? Contact HPES ECS for login

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Review of PCS Billing

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  1. Review of PCS Billing NC Division of Medical Assistance February 2013

  2. NCECSWeb Tool Next slides will present Screen Shots of actual form on Web Tool Web Tool https://webclaims.ncmedicaid.com/ncecs Must have a HPES login and password Don’t have a login? Contact HPES ECS for login 1-800-688-6696, menu option 1

  3. https://webclaims.ncmedicaid.com/ncecs

  4. https://webclaims.ncmedicaid.com/ncecs

  5. https://webclaims.ncmedicaid.com/ncecs

  6. %

  7. Use the modifier listed in Decision Notice Provider receives from CCME

  8. What Billing Questions are directed to HPES? • Denials • Incorrect or Missing Carolina Access Number • Incorrect CPT code • Assistance with the Web Tool • Request for on site visit

  9. RESOURCES • HP Enterprise Services (HPES) – Provider Services • Toll Free Number: 1-800-688-6696 • Division of Medical Assistance (DMA) - http://www.ncdhhs.gov/dma/index.htm • Basic Medicaid and NC Health Choice Billing Guide - http://www.ncdhhs.gov/dma/basicmed

  10. RESOURCES • The Carolina Center for Medical Excellence (CCME) - www.thecarolinascenter.org • CCME’s Call Center is available Monday through Friday from 8:00 a.m. – 5:00 p.m. • Toll Free Number: 800-228-3365

  11. RESOURCES • Special Bulletin Dec 2011 http://www.ncdhhs.gov/dma/bulletin/NCECSWebGuide.pdf • North Carolina Electronic Claims Submission/Recipient Eligibility Verification Web Tool https://webclaims.ncmedicaid.com/ncecs • www.nucc.org • Provides a crosswalk of paper CMS 1500 fields to electronic form equivalent fields

  12. RESOURCES • Place of Service Codes • General Bulletin Dec 2005 • http://www.ncdhhs.gov/dma/bulletin/pdfbulletin/1205bulletin.pdf • PCS Limitations or Requirements • 5.4.1 Place of Service • http://www.ncdhhs.gov/dma/mp/3L.pdf

  13. RESOURCES • Consolidated Personal Care Services http://www.ncdhhs.gov/dma/pcs/pas.html • Bulletins http://www.ncdhhs.gov/dma/bulletin

  14. RESOURCES • www.cms.gov • http://www.cms.gov/medicare-coverage-database/stticpages/icd-9-code-lookup.aspx

  15. QUESTIONS?

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