TribalConsJune2014.Pdf Form

Division of Fee for Service Management update

2 DFSM Statistics Reaching across Arizona to provide comprehensive  quality health care for those in need • 6,429,809-Claims received SFY14 • 86.04%-Percentage of electronic claims • 57,114-Calls received in CCS • 41,034-Calls received in UM/CM • 99.54%-30 day turnaround • 99.95%-90 day turnaround

IHS/638 Recycle • Began the week of May 19th • 255,762 claims to be recycled • 123,970 claims have been completed 3 Reaching across Arizona to provide comprehensive  quality health care for those in need

4 Auditing Reaching across Arizona to provide comprehensive  quality health care for those in need • PERM audit year • High error rate when auditing IHS/638 facilities • Common errors • Part D drugs • Unbundling • No documentation • Non-covered services

5 Training Schedule Reaching across Arizona to provide comprehensive  quality health care for those in need Jun 16 Ambulatory Surgical Center (ASC) Billing Jul 14 Non‐Emergency Transport/ Trip Report (275) Attachment  Jul 28 Submitting a Prior Authorization utilizing the AHCCCS website Aug 11 On‐Line Claim Submission Process Aug 25 How to Submit a Replacement or Voided Claim Online Sep 08 Medicare Remit Easy Print (MREP) Usage Sep 22 To Be Determined Oct 06 To Be Determined Oct 20 Non‐Emergency Transport/ Trip Report (275) Attachment Nov 03 Submitting a Prior Authorization utilizing the AHCCCS website Nov 17 On‐Line Claim Submission Process Dec 01 How to Submit a Replacement or Voided Claim Online Dec 15 Ambulatory Surgical Center (ASC) Billing

6 Important Documents Reaching across Arizona to provide comprehensive  quality health care for those in need • AHCCCS Medical Policy Manual • DFSM FFS Provider Billing Manual • DFSM IHS/638 Provider Billing Manual • IHS/638 Telehealth Manual • AHCCCS Behavioral Health Services Guide http://www.azahcccs.gov/commercial/Provider Billing/manuals/manuals.aspx

Questions? 7 Reaching across Arizona to provide comprehensive  quality health care for those in need

Thank You. 8 Reaching across Arizona to provide comprehensive  quality health care for those in need