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Billing Handbook

Medicaid provider billing handbook description.

Section Topic
  Provider Billing Handbook Cover
  Table of Contents 
  Cover Letter
Section 0.1 Introduction to Billing Handbook
Section 0.2 Quick Reference Billing Tips
Section 0.3 National Correct Coding Initiative (NCCI)
Section 1.0 General Billing Information
Section 1.1 Mississippi Medicaid
Section 1.2 Fiscal Agent
Section 1.3 Electronic Data Interchange (EDI)
Section 1.4 eQHealth Solutions
Section 1.5 Pharmacy Prior Authorization
Section 1.6 Prior Authorization
Section 1.7 National Provider Identifier (NPI)
Section 1.8 Benefits Limits
Section 1.9 Copay and Exceptions
Section 1.10 Eligibility
Section 1.11 Newborns with Medicaid
Section 1.12 Timely Filing
Section 1.13 Fee Schedules
Section 1.14 Denied Claims
Section 2.0 CMS-1500 Claim Form Instructions
Section 2.1 CMS-1500 Billing Modifiers
Section 2.2 Filing Medicare Part B Crossover Claims on the CMS-1500
Section 2.3 Part B Crossover Instructions
Section 3.0 UB-04 Claim
Section 3.1 Filing Medicare Part A Crossover Claims on the UB-04
Section 3.2 Part A Crossover Claim Form Instructions
Section 4.0 Dental Claim Form
Section 5.0 Pharmacy
Section 5.1 Pharmacy Claim Instructions
Section 6.0 Third Party Liability (TPL) General Information
Section 6.1 Preferred Provider Organizations (PPO)
Section 6.2 Billing Third Party Source
Section 6.3 Third Party Source for Maternity Claim
Section 6.4 Assignment of Benefits
Section 6.5 When Beneficiary Denies Insurance Coverage
Section 6.6 Billing Medicaid after Receiving a Third Party Payment or Denial
Section 6.7 Receipt of Duplicate Third Party Money and Medicaid Payment
Section 6.8 Hospital Retroactive Settlements
Section 6.9 Exceptions to Cost Avoidance and Casualty Cases
Section 6.10 Billing Medicare
Section 6.11 Third Party Sources
Section 7.0 Remittance Advice (RA)
Section 7.1 Remittance Advice Cover
Section 7.2 Remittance Advice Message Page
Section 7.3 Remittance Advice Header Page
Section 7.4 Remittance Advice Paid/Denied Claims
Section 7.5 Remittance Advice Claim Header/Line Information for Adjustments
Section 7.6 Suspended/Pended Remittance Advice Field Descriptions
Section 7.7 Provider Adjustments/Legend Page
Section 8.0 Adjustment/Void Request Form
Section 8.1 Claim Inquiry
Section 9.0 Miscellaneous Information and Forms in Appendix
Section 9.1 Glossary and Acronyms
Section 9.2 Forms

 

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