MAPS-MD Issues Bulletin		May 1999

Claims Timely Filling Limit:

Just a reminder, effective May 15, 1999 all Medical Assistance claims for FY’98 (July 1, 1997 - June 30, 1998) had to be submitted to MAPS-MD for processing. Claims for these dates of service can no longer be accepted by MAPS-MD. Keep in mind the nine month timely claim filing rule is now in effect, with 60 days granted for resubmittals, thus allowing a total of eleven months from date of service for claims billing. This eleven month cut off is in effect for all dates moving forward. Please be sure that all claims are submitted to MAPS-MD within these time frames.

The same timelines guidelines apply to Gray Zone FY’98 claims effective June 1, 1999, with a final submission deadline of July 15, 1999. The submission deadlines (nine months plus 60 days) are in effect moving forward.

On-Site Provider Audits:

This is an ongoing process
Provider will be contacted directly by IHAS to schedule the appointment
At lease 10 charts will be reviewed for documentation
IHAS has been given this authority by MHA through MAPS-MD
The results are forwarded to the Mental Hygiene Administration

Case Management Authorizations:

An authorization for the annual Case Management Evaluation is no longer necessary. Case Management providers can bill for the evaluation one time per year as long as they are authorized for case management services

Gray Zone Consumers:

Just a reminder: When a consumer moves from Medical Assistance back to Gray Zone, the provider should notify MAPS-MD. This can be done by sending an e-mail message through the Gray Zone Web Site (www.gzmd.com). To access the Gray Zone Web Site, you must obtain a User ID and password. This can be obtained by e-mailing Bob Atwood at bbatwood@apshealthcare.com.

Attention electronic billers for MAPS-MD
(HCFA 1500 Sumbitters ONLY)
IMPORTANT / IMPORTANT / IMPORTANT INFORMATION
1. By September 1, 1999 the following must be in place for HCFA 1500 Electronic Claims Submission:

In the header record for all HCFA 1500 claims, the following must be completed:

MAPS-MD

P.O. Box 624 (this is address field 1)

Owings Mills, MD 21117 (this is address field 2)

If this information is missing after September 1, 1999, claims will be rejected on Med Link edits and returned to you on the Error Log and not sent to MAPS-MD for processing. IF YOU NEED ASSISTANCE in determining where this field is located, please have your technical support person contact Med Link customer service (1-800-438-2524).

2. Please be sure you are using valid diagnosis codes, based on the ICD-9 code listing. Within the next few weeks, Med Link will begin implementing edits that will reject claims if they do not have an ICD-9 code listed or if the diagnosis code listed is not found in the ICD-9 coding book. These will appear on your Error Log as rejected claims and will not be sent to MAPS-MD for processing. MAPS-MD will send out another update as to when this will be implemented.