Where do I submit claims to MediPass?

Where do I submit claims to MediPass? What is the claim address and can it be submitted electronically? 
 I have contacted different Medicaid provider phone numbers, but I have not received any response back.

Claims for recipients in MediPass are billed just like any other Medicaid claim. Please consult the appropriate billing handbook Florida Medicaid Provider Reimbursement Handbook, CMS-1500, Florida Medicaid Provider Reimbursement Handbook, UB-04; etc. Or contact Provider Support with the Medicaid Fiscal Agent.

You will find the contact information for the fiscal agent, HP Enterprise Services, at: https://portal.flmmis.com/FLPublic/Portals/0/StaticContent/Public/Training/032409%20Complete%20General%20Information.pdf . The claims addresses are in the center of the page. The Medicaid Area Office for your county can also assist.

Is the NPI# the authorization number for MediPass kids? I have some pediatricians who write their NPI# as authorization and others who put their Medicaid #.
No. The National Provider Identifier (NPI) number cannot be used to replace the MediPass authorization number. Providers who are not sure what to use as the MediPass authorization number should contact their Medicaid Area Office. NPI numbers are 10 digits while the MediPass authorization numbers will be 9 digits.

Do MediPass patients have dental benefits?
Dental services do not require prior approval or referral by the MediPass primary care provider, except in an area with the Prepaid Dental Plan. Some Medicaid HMOs cover dental services. If the HMO does not cover dental services, they may be covered by a Prepaid Dental Plan. Such plans currently operate in Miami-Dade, and they will expand statewide starting in 2012. If the person is not in a prepaid dental plan, the person would be covered under the fee-for-service Dental Services for Children or Dental Services for Adults. Note that the services for adults are very limited. Currently the following health plans cover optional (State Plan) dental services in all of their non-Reform counties of operation: JMH, Healthy Palm Beaches, Integral, Sunshine, and Molina. Beginning on January 1, 2012, only the following health plans will cover optional (State Plan) dental services: Healthy Palm Beaches, Integral, and Molina. Please be careful to request service authorization and to bill accordingly. Information on the implementation of the Statewide Prepaid Dental Health Plan program is available at the following website: www.AHCA.MyFlorida.com/MedicaidPDHP

1 comment:

Anonymous said...

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