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MAPS-MD Issues Bulletin
January 2001
New Sliding Fee Scale for Uninsured Consumers
The Department of Health and Mental Hygiene released a new sliding fee scale for uninsured consumers, effective 1/1/2001 (see attachment). This change affects anyone who is newly registered as a gray zone consumer with MAPS-MD after 1/1/2001 or who needs to be re-registered after 1/1/2001. Those consumers that have existing eligibility / copay assignments that are effective until a later date in 2001 will not be affected until they are re-registered and a new copay determination is made.
Update on Long-Term Care Span Process
Maryland Health Partners coordinated a meeting on January 11, 2001 held at Spring Grove Hospital Center to discuss the process for establishing long-term care spans for medical assistance recipients. Representatives from the Mental Hygiene Administration, Maryland Health Partners, Department of Health and Mental Hygiene and the Department of Human resources each described their "piece" of the process and were available to answer questions concerning the process. Thirteen RTC/IMDs were represented, as were five CSAs.
Reminder: Total Charge Amount for HCFA 1500
Providers must bill with a charge amount and a total charge amount. Neglecting to do this may result in denied claims.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
The State of Maryland Department of Health and Mental Hygiene and Maryland Health Partners have begun an analysis of the recently released HIPAA rules and the impact they will have on providers submitting claims to the State of Maryland and Maryland Health Partners. Information will be published on the Maryland Health Partners web site (http://www.MAPS-MD.com) regarding the implementation of required changes. For general HIPAA information and links, visit the HCFA (Health Care Financing Administration) web site at http://www.hcfa.gov/hipaahm.htm.
Reminder: UB-92 Claim Submission Guidelines
The same revenue code cannot be duplicated on a single claim. If rate changes have occurred during the course of an admission, multiple claims should be submitted to MAPS-MD. The submission of claims with duplicate revenue codes will result in delay or denial of payment.
System Enhancements and Gray Zone
Recently MAPS-MD has added several system enhancements affecting gray zone; therefore, MAPS-MD is requesting that all providers check their web site passwords. If you find any issues regarding passwords, please notify Terri Yox at 410-953-1829.
Consumers and Claims Billing Information
It is inappropriate for providers to instruct consumers to phone MAPS-MD regarding claims billing information.
Reminder: Claims Dept. Address
Claims being sent through regular mail should still be sent to P.O. Box 624, Owings Mills, MD 21117. If you are overnighting claims for MAPS-MD, you need to address them to: MAPS-MD Claims, 7125 Thomas Edison Drive, Suite 250, Columbia, MD 21046.
Do Not E-Mail Consumer Information
Providers should note that it is not acceptable to e-mail patient information to MAPS-MD. Instead, for correspondence regarding consumers, providers should use regular mail or fax. E-mailing consumer information poses a potential breach of confidentiality.
Clarification: Department of Juvenile Justice (DJJ) Consumers
DJJ consumers in state-run facilities lose their Medicaid eligibility. DJJ consumers in privately run DJJ facilities maintain their MA. In some cases, however, the DJJ consumers may still be identified in the Medicaid Electronic Verification system (EVS) as having MA because the DJJ status has not been passed on to MA. Therefore, all children in the state-run DJJ boot camp program should be assumed to be without MA, even if EVS indicates the opposite.
Reminder: Authorization Letter Turn-Around Time
It is generally expected that one week after receipt of a treatment plan, MAPS-MD will attempt to release the authorization letter, either by fax or mail. There may be instances where the treatment plan is not able to be processed, and it will be returned to the provider. If you have not already signed up for the authorization fax program and would like to do so, please fill out the attached form.