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CHAMPS Presentation School Based Services Liaison meeting

Learn about the latest updates and functions of the CHAMPS system for provider services on February 25, 2010. Get details on eligibility checks, claims entry, and more. Stay informed for seamless billing processes.

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CHAMPS Presentation School Based Services Liaison meeting

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  1. CHAMPS PresentationSchool Based Services Liaison meeting February 25, 2010 Lisa Trumbell, Provider Liaison Lynn Hicks, Provider Support

  2. CHAMPS • Replaces old system Functions: • Check Eligibility • Enter claims on-line (Direct Data Entry) • On-line Claim adjustments/voids • Status claims

  3. 835 reporting old HIPAA Format • 835 now reporting on the correct HIPAA Format: 4010X091-A1 • Unique Identifier not reporting or reporting inconsistently on the 835. Defect filed 2/22/10.

  4. CHAMPS Eligibility • Benefit Plan should = MA (Medicaid Fee-For-Service) • If Eligibility returns: MC-MA (Medicaid Managed Care) it must also have MA listed as a separate Benefit Plan

  5. Eligibility Duplicate ID’s: • MPHI will post a toll free number on www.mihealth.org • Toll Free number customer service representatives specialized in assisting w/ duplicate ID corrections

  6. Updates: Issues: • V2799 Vision Services Misc rejecting for Prior Auth. Required. This code does not Require PA. Scheduled for 2/26/10 release. 2) Reason code 31: Patient Cannot be identified as our insured. - Benefit plan & Procedure code identification issue. Procedure excluded from Benefit plan in error. Claims processing to correct as this edit appears.

  7. Updates Issues: 3) Diagnosis code does not support Procedure code: Affected all codes. Claims pending. Status: Corrected. Dx codes now loaded. MDCH to release the pended claims.

  8. Updates: Issues: 4) Reason Code 18 Exact Duplicate Resolution: Inquire on claim in CHAMPS using TCN, click TCN hyperlink, click claim line hyperlink, in show menu select ClaimLimit list to view duplicate claim TCN.

  9. Updates Issue: 5) Remark Code: 204 Service/equipment/drug not covered under patient’s benefit plan. Resolution: Confirm beneficiary has MA as a benefit plan. Confirm procedure code in SBS fee screen.

  10. Updates Issue: 6) T1024 Team Eval. & Management Rejecting incorrectly w/ Reason Code: 204 Status: MDCH reviewing

  11. Updates CHAMPS Updates can be found at: www.michigan.gov/mdch click CHAMPS scroll down to CHAMPS Provider Update Table

  12. SBS Training • SBS specific billing & CHAMPS training in June, 2010 (Date, location TOB) • Navigational Sessions (TOB) • Visit: www.michigan.gov/mdch click CHAMPS scroll to Medicaid Provider Training

  13. CHAMPS Resources For CHAMPS Navigation issues: CHAMPS Helpline: 1-888-643-2408 or champs@michigan.gov For Billing Questions: Provider Inquiry: 1-800-292-2550 or providersupport@michigan.gov

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