MHCP Provider News

July 27, 2015 News


  • • Web page user surveys: MHCP is in the early stages of a process to improve the navigation structure and content of our web pages for Partners and Providers and for Counties and Tribes. If you and your colleagues go to those pages to do your jobs, we would like to hear from you. We plan to conduct occasional online surveys. Each will take approximately 15 minutes. Please join a user feedback panel by taking the first survey. For more information about the project, contact Jon Wittman, DHS online content manager, at 651-431-5880 or jonathan.wittman@state.mn.us. (Added 7/29/15)
  • • Home and Community-Based Services (HCBS) waiver transportation policy: DHS recently posted a draft of proposed changes to the current HCBS transportation page in the Community-Based Services Manual (CBSM). DHS would like your input on the changes, specifically, 1) what did we miss that should be added? and, 2) what needs clarification? The 30-day public comment period began at 9 a.m. Wednesday, July 22 and ends at 4 p.m. Friday, Aug. 21, 2015. Submit comments to DSD.PublicComments@state.mn.us
  • • 2015 Quality Improvement Tool is Available: DHS notified home and community-based services (HCBS) providers (PCA and Waiver) and intermediate care facilities for persons with developmental disabilities (ICF-DD) through their MN–ITS PRVLTR folder that the 2015 Quality Improvement Tool launched on July 1, 2015. Providers may now submit a quality improvement project plan in the updated 2015 tool through Dec. 31, 2015. For more information, visit the long-term services and supports quality improvement web page.
  • • Claims Clinic Survey: Minnesota Health Care Programs (MHCP) invites you to take a short survey to help us decide whether we should offer in-person billing clinics to providers. Beyond offering a face-to-face overview of our billing procedure, in-person billing clinics would allow you to bring your own claims and go over them with an instructor at the end of the session. Please take this 2015 Claims Clinic Survey as soon as you can.

  • Review recent Provider Updates:


    Payment Error Rate Measurement (PERM)

    The Centers for Medicare & Medicaid Services (CMS) will host four PERM provider education sessions during fiscal year 2015. Watch for more information or refer to the CMS PERM website. The PERM overview video, PERM: Responding to Medical Records/Documentation Requests, is available on the CMS YouTube channel. If you have PERM questions, call or email Laurie Grussing, Manager, 651-431-3959, laurie.grussing@state.mn.us or Eileen Dejdar, RN, 651-431-3944, eileen.dejdar@state.mn.us.

    Training and VideoPresence Opportunities

    Refer to the session for registration and session details:

  • • Adult Rehabilitative Mental Health Services (ARMHS) Information Seminar
    Providers interested in becoming an ARMHS provider are required to attend an ARMHS Information Seminar. Qualified clinical supervisors or clinical consultants, as well as the administrative representative of the potential ARMHS provider must register for the seminar. DHS provides these seminars quarterly. Seminars will be July 17, 2015, Oct. 16, 2015, Jan. 15, 2016, and April 15, 2016. All seminars will be on Fridays from 8:30 a.m. to 12:30 p.m. Information to enroll in the seminar, as well as additional information about the clinical supervisors’ prerequisite online training is on the AMHD Training Website.
  • • Early Intensive Developmental and Behavioral Intervention (EIDBI)
    DHS is postponing the Comprehensive Multi-Disciplinary Evaluation (CMDE) and Individual Treatment Plan training until a later date to allow more time to resolve related EIDBI benefit implementation details. We will provide more information soon.

  • MN–ITS

    Some waiver claims denied incorrectly – resubmit
    Minnesota Health Care Programs (MHCP) identified an issue for some waiver claims submitted on July 9, 2015, and July 10, 2015. If you submitted a claim via batch or MN–ITS DDE, and the claim was denied incorrectly, resubmit the claim. The issue has been resolved.

    Acknowledgment responses
    For batch files submitted June 15, 2015, verify that you received a response and that the response includes the requested information. If you received a miscellaneous file that shows as zero bytes, call the Provider Call Center to have a ticket created.

  • • PDF Remittance Advices (RAs)
    Some PDF RAs are also showing as zero bytes and do not open when selected. We have replaced these RAs with the corrected files. You do not need to call the Provider Call Center about these. The corrected RA in your mailbox will have the date of June 16, 2015, and the name of the file will end with an underscore (_.pdf).
  • • Electronic Remittance Advices (835 X12)
    Due to a system delay, we have not yet sent 835 X12 files to most providers. We are working to correct the issue and send these files as quickly as possible.

  • MN–ITS account – Register your account to receive revalidation requests timely
    Register your MN–ITS account to receive important communication electronically. MHCP places information into the PRVLTR folder of your MN–ITS mailbox so you can get it immediately and have more time to review and respond to time sensitive requests. If you received your revalidation request letter through the U.S. Postal Service, you need to register your MN–ITS account.

    The Welcome Letter you received when you first enrolled has instructions to register your account. If you do not have a copy of your Welcome Letter, call the MHCP Provider Call Center to ask for a copy. When you register your account, you can choose who you want to be in charge of the account as the administrator. This person will be able to give others access, if needed, and check the mailbox regularly for communication from MHCP.

    MN–ITS announcements and availability
    Refer to the 5010/D.0 Announcements page for information about MN–ITS functionality, technical information, scheduled downtimes and other notifications.

    Industry Initiatives

    This Industry Initiatives section gives you quick, easy access to current federal and state industry initiatives that potentially impact your business. Please review these pages on a regular basis.

    5010/D.0

    Watch the 5010/D.0 page for announcements about both direct data entry (DDE) and batch transactions. We also add messages about MN–ITS availability on this page.

    ICD-10

    Beginning July 6, 2015, MHCP is opening the MN–ITS test environment for all enrolled providers to submit ICD-10 testing claims. Refer to the MHCP ICD-10 page for more information about implementation and testing with us.

    Minnesota Health Care Programs (MHCP) is asking for feedback from all enrolled providers about ICD-10 testing. Your responses will help us decide how to best support testing for all providers. Please complete the short ICD-10 Claims Testing Survey now. It will take less than five minutes of your time. Thank you for your participation.

    Dental Services

    Dental rate increase outside of Twin Cities metropolitan area
    On July 1, 2015, MHCP increased dental payment to providers located outside of the seven-county metropolitan area by 9.65%. The increase does not apply to state-operated dental clinics, federally qualified health centers (FQHCs), rural health centers (RHCs), and Indian health service (IHS) providers. Payments made to managed care organizations (MCOs) and managed care county-based purchasers (CBPs) outside the seven-county metro area will reflect this new increase beginning Jan. 1, 2016.

    Early Intensive Developmental and Behavioral Intervention (EIDBI)

    The EIDBI Provider Manual and EIDBI Provider Enrollment page is now available. In addition, refer to the EIDBI Policy Guide. We will continue to update information in the guide, so check back frequently. We will also provide more information about EIDBI when it becomes available.

    Assurance statements
    EIDBI provider assurance statements are now available. Please refer to
    provider qualifications in the EIDBI Policy Guide and complete any of the relevant forms listed below to begin the EIDBI enrollment process:


    These EIDBI assurance statements are also available in DHS’ eDocs searchable document library.

    Essential Community Supports (ECS)

    MHCP has completed the programing in MN–ITS to identify eligibility for members on the Essential Community Supports (ECS) program. Effective immediately, the Service Agreement (SA) will no longer be adequate verification of eligibility. You must check eligibility for all members through the Eligibility Verification System (EVS) or MN–ITS.

    Fiscal Support Entities (FSE)

    The 2015 Minnesota Legislature authorized an additional 1.53 percent rate increase for personal assistance services and budgets for the following:

  • • Consumer directed community supports (CDCS)
  • • Consumer Support Grant (CSG)
  • View information on How to implement the CDCS and CSG 1.53 percent rate increase.

    Hearing Aids

    MHCP added two new HCPCS codes, V5281 and V5282, to the current 2014 Hearing Aid Contract. Use these codes when billing whole frequency modulation (FM) or digital modulation (DM) personal systems. Individual system components, codes V5283 –V5289, cannot be billed together on the same claim due to NCCI edits.

    Hospice Services

    To receive payment for hospice services, the elected hospice provider must fax a completed copy of the MHCP Hospice Transaction Form (DHS-2868) (PDF) to MHCP at 651-431-7554, within two days of the recipient electing hospice care.

    When providing hospice services to a dual eligible (Medicare and Medical Assistance) recipient, the hospice provider must fax either the Medicare approved criteria, plus the required MHCP hospice documentation requirements, or the Hospice Transaction Form. Documentation must indicate Medicare Hospice Election. MHCP may deny clams if this information is missing for dual eligible clients.

    Please verify and submit the necessary hospice information for dual eligible clients. In certain situations it may be necessary to fax this form to other agencies or to case managers. Follow the instructions provided in the Hospice Services section of the MHCP Provider Manual.

    Hospitals

    Effective for dates of service on or after July 1, 2015, the rate for Direct Observation will follow the CMS pricing guidelines using the Outpatient Ambulatory Payment Classification payment rate. Once our system work is completed, claims will be reprocessed back to July 1, 2015.

    Individualized Education Program (IEP)

    On July 8, 2015, DHS sent an email to school contacts announcing IEP Fall Training dates for 2015. Unfortunately, many of the emails were undeliverable because of outdated information on our IEP Provider Contact List. Please update your IEP provider contact information as soon as possible to prevent missing important messages and notices.

    Laboratory, Pathology, Radiology and Diagnostic Services

    Effective Aug. 1, 2015, the authorization system for receiving an immediate response for certain imaging services will no longer be available. All authorization requests for imaging services will need to be submitted to the medical review agent (KEPRO). For additional information, refer to the MHCP Fee Schedule for the current authorization requirements for specific imaging services, and to the Laboratory/Pathology Services section of the MHCP Provider Manual.

    Personal Care Assistance (PCA)

    Rate increase
    The 2015 Minnesota Legislature authorized an additional 1.53 percent rate increase for personal assistance services and budgets. View information on How to implement the CDCS and CSG 1.53 percent rate increase.

    Requests for resubmission
    Effective Aug. 17, 2015, MHCP will begin putting the Request for Resubmission (DHS-5678) into the agency’s MN–ITS mailbox instead of faxing them back when we are not able to complete processing applications for individual personal care assistants (PCA).

    Transportation

    All nonemergency medical transportation (NEMT) providers must be certified for special transportation services (STS) by MnDOT. STS providers enrolled with Minnesota Health Care Programs (MHCP) must complete the MnDOT certification process. Access transportation service (ATS) providers providing transport by working with the local county or tribal agency must either complete the MnDOT special transportation services certification process or complete the STS Variance Request (DHS-3896) and submit it to DHS Provider Enrollment. Volunteer drivers, publicly operated transit systems, and not-for-hire vehicles are not subject to this requirement.

    Waiver and AC Program Providers

    During the MMIS and COLA or rate increase process that ran June 9, 2015, a discrepancy appeared in the PCA rate for T1019 procedure codes on service agreement lines starting July 1, 2015, or later. The discrepancy only affects BI, CAC, CADI, DD, Elderly Waiver and Alternative Care service agreements. Other service agreement types, such as type B agreements, were not affected. You must wait for the lead agency to correct the SA.

    Related Links

    Visit our Provider website for more comprehensive information, including these pages:

  • Latest Manual Revisions
  • • Previously published Provider News items
  • Provider Updates (we also place newly published Provider Updates in your MN–ITS Mailbox, as appropriate)

  • This page includes news and resources for providers enrolled to serve Minnesota Health Care Programs (MHCP) recipients. Get notices of Provider News through our free Provider Email Lists.

    If you have questions about this information, call the MHCP Provider Call Center at 651-431-2700 or 800-366-5411.

    Sign up to receive Provider Updates and other MHCP notices in your email account.


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