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This document serves as a companion guide to the HIPAA ANSI X12N implementation guides for submitting health care claims and encounter data to a payer for payment in the Commonwealth of Kentucky's

How to fill out ky medicaid mmis batch

How to fill out KY Medicaid MMIS Batch Health Care Professional Health Care Claim And Encounter Claims (837P) Companion Guide

1. Gather all necessary patient and provider information.
2. Ensure you have the correct claim form and version of the 837P format.
3. Enter patient demographic details such as name, date of birth, and Medicaid ID.
4. Include provider information including National Provider Identifier (NPI) and taxonomy codes.
5. Fill in the service details including CPT/HCPCS codes, service dates, and charges.
6. Provide any required modifiers that apply to the services billed.
7. Attach any necessary documentation that supports the claim.
8. Review all entries for accuracy and completeness to avoid claim rejection.
9. Submit the completed 837P file to the KY Medicaid MMIS system.

Who needs KY Medicaid MMIS Batch Health Care Professional Health Care Claim And Encounter Claims (837P) Companion Guide?

1. Healthcare providers submitting claims to KY Medicaid.
2. Billing staff responsible for managing and processing medical claims.
3. Organizations and administrative personnel dealing with Medicaid billing procedures.
4. Anyone involved in the preparation or submission of health care claims in Kentucky.

People Also Ask about

What is provider type 31 in Kentucky Medicaid?

Federally Qualified Health Center (FQHC)/Non-FQHC - PT (31) ​​​​​​The Federally Qualified Health Center (FQHC)/Non-FQHC program is identified by Kentucky Medicaid as Provider Type (31) and may bill Kentucky Medicaid using this provider type number.

What is the phone number for Medicaid provider relations in KY?

Contact Information Electronic Claims800-205-4696 Provider Enrollment 877-838-5085 Provider Enrollment Fax No# 502-226-1898 Automated Voice Response System Claims Status Inquiries 800-807-13012 more rows

What programs and services are available from KY Medicaid?

Programs and Services and Cervical Cancer Treatment Program. Early Periodic Screening, Diagnosis, and Treatment Services (EPSDT) Program. Medicare Savings Plan Program. Medicaid Works. School-Based Health Services. Tobacco Cessation. Medicaid Waivers. Health Access Nurturing and Development Services (HANDS)

What is Medicaid type?

Medicaid is a joint federal and state program that helps cover medical costs for certain low-income people, families and children, pregnant women, the elderly, and people with disabilities. Medicaid also helps cover medical costs for other adults.

What is the timely filing limit for a Kentucky Medicaid claim?

In ance with federal regulations, claims must be received by Medicaid no more than 12 months from the date of service, or six months from the Medicare, Medicare Part C (Medicare Advantage), or other insurance payment date, whichever is later.

What are the different Medicaid plans in Kentucky?

NCQA Health Insurance Plan Ratings 2019-2020 - Summary Report (Medicaid) RatingPlan NameStates 3.5 Aetna Better Health of Kentucky KY 3.5 Anthem Kentucky Managed Care Plan, Inc. KY 3.5 WellCare Health Insurance of Illinois, Inc. dba WellCare of Kentucky, Inc. KY 3.0 Humana Health Plan, Inc. (Kentucky) KY1 more row

What is provider type 64 in Kentucky Medicaid?

​Kentucky Medicaid identifies physician service providers as Provider Type (64) individual or (65) group. To enroll and bill Kentucky Medicaid, physician service providers must be: Licensed in the state in which they operate.

What is a provider type code?

A code describing the type of provider (i.e. doctor or facility) responsible for treating a patient. This represents the attending physician if available. If the state uses state-specific codes, they should map their internal codes to the CMS standard list provided. SOURCE: T-MSIS Analytic File (TAF) Claims.

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What is KY Medicaid MMIS Batch Health Care Professional Health Care Claim And Encounter Claims (837P) Companion Guide?

The KY Medicaid MMIS Batch Health Care Professional Health Care Claim and Encounter Claims (837P) Companion Guide is a document that provides detailed instructions and guidelines for submitting professional health care claims and encounter data to Kentucky Medicaid using the 837P format.

Who is required to file KY Medicaid MMIS Batch Health Care Professional Health Care Claim And Encounter Claims (837P) Companion Guide?

Health care providers who render professional services and wish to submit claims for reimbursement to Kentucky Medicaid are required to file using the KY Medicaid MMIS Batch Health Care Professional Health Care Claim and Encounter Claims (837P) Companion Guide.

How to fill out KY Medicaid MMIS Batch Health Care Professional Health Care Claim And Encounter Claims (837P) Companion Guide?

To fill out the KY Medicaid MMIS Batch Health Care Professional Health Care Claim and Encounter Claims (837P) Companion Guide, providers should follow the specific formatting and data field instructions outlined in the guide, ensuring accuracy in patient information, provider details, service codes, and billing information.

What is the purpose of KY Medicaid MMIS Batch Health Care Professional Health Care Claim And Encounter Claims (837P) Companion Guide?

The purpose of the KY Medicaid MMIS Batch Health Care Professional Health Care Claim and Encounter Claims (837P) Companion Guide is to standardize the electronic submission of health care claims, ensuring compliance with Medicaid regulations and improving the efficiency of claims processing.

What information must be reported on KY Medicaid MMIS Batch Health Care Professional Health Care Claim And Encounter Claims (837P) Companion Guide?

The information that must be reported includes patient demographic details, provider identification numbers, service dates, procedure codes, diagnosis codes, and any other relevant billing information as specified in the guide.