Information Letter No. 18-07 - Addressed to Nursing Providers. Nursing Facility (NF) providers MUST ensure that a designated resident has a valid Daily Care service authorization reflected on the Medicaid Eligibility Service Authorization Verification (MESAV) at the significant steps in the submission and approval process for NF Specialized Services. The letter addresses how to minimize billing issues. NF staff must ensure all appropriate and necessary forms and assessment submissions have … [Read more...] about Daily Care Service Authorization Necessary for the (PASRR) Specialized Services Authorization
Nursing Providers: Avoiding Common Errors that Result in Nursing Facility Specialized Services Denial
Information Letter No. 18-02 -Nursing Facility providers often make two common mistakes that usually result in denial of authorization requests or Health and Human Services Commission (HHSC) Preadmission Screening and Resident Review (PASRR) NF specialized services or assessments. To avoid this error, DADS has published this letter to help avoid these errors. The two most common reasons HHSC denies authorization requests for PASRR specialized services and assessments are: 1. NF staff … [Read more...] about Nursing Providers: Avoiding Common Errors that Result in Nursing Facility Specialized Services Denial
Fiscal Year 2017 Cutoff Dates for Fee-for-Service Year-end Closeout Processing
Information Letter No. 17-17This is a reminder that, with the fiscal year change, any claims for services performed in fiscal year 2015 (September 1, 2014 to August 31, 2015) that TMHP receives after Noon, Tuesday, August 8, 2017, will become miscellaneous claims and cannot be paid through the standard Claims Management System payment process. Fiscal Year 2015 Miscellaneous Fee-for-Service (FFS) Claims Cutoff:Noon, Tuesday, August 8, 2017Fiscal Year 2017 FFS Claims Processing Cutoff: Noon, … [Read more...] about Fiscal Year 2017 Cutoff Dates for Fee-for-Service Year-end Closeout Processing
Federal Re-Enrollment DEADLINE
Federal Re-enrollmentAs a requirement of the Patient Protection and Affordable Care Act (PPACA), state Medicaid agencies must revalidate the enrollment of all providers by September 24, 2016. It is has passed!Texas Medicaid established an application submission deadline of June 17, 2016 which ensured providers of continued enrollment if a complete application was submitted by that date. Providers that missed the application submission deadline may still be able to complete the revalidation … [Read more...] about Federal Re-Enrollment DEADLINE
New Billing Codes for Preadmission Screening and Resident Review Custom Manual Wheelchair Assessments
The purpose of this letter is to notify nursing facility providers that effective February 1, 2016, assessments, completed on or after February 1, 2016, to determine whether a Medicaid eligible, positive Preadmission Screening and Resident Review (PASRR) resident with IDD would benefit from a Custom Manual Wheelchair (CMWC), must now be billed as a separate service using the information provided below. Providers should refer to the Long Term Care (LTC) Bill Code Crosswalk for complete details. … [Read more...] about New Billing Codes for Preadmission Screening and Resident Review Custom Manual Wheelchair Assessments
Nursing Facility Transition REVISED by DADS: Nursing Facility Changes to the Medicaid Claims Submission Process
The Department of Aging and Disability Services is re-issuing this letter to provide updatedinformation about effective dates for the changes discussed in the original letter. The original letter(Information Letter 2014-68, Nursing Facility Transition: Nursing Facility Changes to theMedicaid Claims Submission Process) was posted on October 21, 2014. This letter replaces thepreviously published letter. In conjunction with the transition of nursing facilities (NFs) to STAR+PLUS managed care … [Read more...] about Nursing Facility Transition REVISED by DADS: Nursing Facility Changes to the Medicaid Claims Submission Process
Medicaid Hospice Rates for Federal Fiscal Year 2015
The Texas Health and Human Services Commission (HHSC) approved rate changes for theMedicaid Hospice program based on information provided by the Centers for Medicare andMedicaid Services (CMS). The new rates, which are retroactive to 10/01/2014, can be accessedthrough the HHSC Rate Analysis website at the following address:http://www.hhsc.state.tx.us/rad/long-term-svcs/hospice/index.shtml For federal fiscal year 2015, CMS approved two payment rates following the quality reportingrequirements … [Read more...] about Medicaid Hospice Rates for Federal Fiscal Year 2015
