2. ICF-MR PROVIDER TRAINNG Sandhills Center LME/MCO

3. SHC Waiver Implementation Date 12/01/2012

4. Submission of Claims Provider can submit claims to: > Rubicon Contract in place with Rubicon Serves as Member Company agent for providers with a contract Addresses claims, billing, or payment issues between Member Company and Sandhills

5. Submission of Claims-Cont. >Sandhills HIPAA standard EDI Transaction Files 837 Professional Health Care Claim 837 Institutional Health Care Claim Companion Guides are located on the SHC Website www.sandhillscenter.org For Provider>Finance/Claims

6. >Sandhills Direct Data Entry Web Tool User Guide is located on the SHC Website www.sandhillscenter.org For Providers>Finance/Claims >Paper Claim Submission of Claims-Cont.

7. Sandhills Direct Data Entry Password To request your DDE Web Tool login and password: Please fill out the SHC DDE request form located on our website: www.sandhillscenter.org www.sandhillscenter.org Click on For Providers >Finance/Claims

8. Paid Claims and Denials Remittance Advice will be available via: Electronic 835 – Share File Paper Providers may also view claims on line Payments/Checks will be available via: Electronic Fund Transfer (EFT) –To sign up, complete EFT form on SHC website: www.sandhillscenter.org For Providers>Finance/Claims Paper

9. Keeping Current It is the responsibility of the provider to research and stay abreast of new requirements and laws by utilizing all available resources: Monthly Medicaid Bulletins DMA and DMH Implementation Updates www.ncdhhs.gov/dma/ SHC Communications/Bulletins SHC Website www.sandhillscenter.org www.sandhillscenter.org

10. Other Resources SHC Provider Helpdesk Phone:1-855-777-4652 Email:providerhelpdesk@sandhillscenter.org SHC Website www.sandhillscenter.org www.sandhillscenter.org For Provider>Finance/Claims EOB Crosswalk Rates UB04