| Retroactive Eligibility Verification
Maryland Health Partners will now accept
the date of eligibility determination from the MMIS
II recipient file as the definitive date of eligibility
determination. Providers will have nine months from
the retroactive determination date to file claims for
services rendered to consumers for whom the determination
was made between the date that eligibility begins to
the date of the retroactive determination as indicated
in MMIS II system.
Online Provider Search
On June 10, 2002, MAPS-MD launched its new
online provider search application.
It's available both on this website, as well as on APS healthcareAssist,
the consumer website. This application will enable consumers
to search the list of providers enrolled with Maryland
Health Partners who can especially meet certain criteria
such as location and specialties. In addition, the application
will also enable MAPS-MD providers to view their information
on file with MAPS-MD. Please note, any discrepancies in
the provider data should be submitted to the MAPS-MD Provider
Relations Department in writing. Complete the Provider
Action Request Form and fax or mail it to:
MAPS-MD
PO Box 3190
Columbia, MD 21045
Attn: Provider Relations
Fax: 410-953-1856 |
Summer PRP Program
To facilitate the authorization of consumers
into the Summer PRP Program, please see the following:
- To obtain authorization, please complete
and fax the form
to MAPS-MD at 1-410-953-1903.
- Please use the confirmation
of authorization plan form to assure notification
that the request for PRP programming has been received.
- MAPS-MD will issue an authorization letter
for this additional service.
- Please note, if you are planning
to admit a child/adolescent who is not currently authorized
for PRP services into your summer program, you must
contact an MAPS-MD Care Manager to review this request
for service and assure that medical necessity is met.
Reminder: CSA Authorizations
Initial RRP authorizations by the CSA
must include authorization for off site PRP services.
Providers must call MAPS-MD to request authorization for
onsite PRP services.
Provider Negative Balance Report
We have provided instructions for interpreting
the MAPS-MD Provider Negative Balance Report.
Diagnosis Code Update
Please note that diagnosis code 311,
which is noted on the Revised
Listing for 3/28/02 as an accepted code was improperly
coded in our claims system. This has since been corrected
with all claims with this diagnosis code now being processed
correctly.
Retraction Notice Reminder
There are 30 days to compare/research
past billing accounts, with an additional 60 days to
submit corrected claims. We encourage you to follow
this procedure:
- Read the entire report carefully
and compare it to your past bills (EOPs).
- If you have questions, please contact
Customer Service at 1-800-565-9688.
- There is an internal process that
must be followed in order to help the providers, but
the first step is to contact customer service.
Reminder: New Claims Address
Effective June 1, 2002, all MAPS-MD claims
should be sent to the following address:
PO Box 3000
Columbia, MD 21046 |
This address replaces the PO Box 624,
Owing Mills, MD 21117 address.
Authorization
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