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CHAMPS Presentation School Based Services Liaison meeting February 25, 2010 Lisa Trumbell, Provider Liaison Lynn Hicks, Provider Support.

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Presentation on theme: "CHAMPS Presentation School Based Services Liaison meeting February 25, 2010 Lisa Trumbell, Provider Liaison Lynn Hicks, Provider Support."— Presentation transcript:

1 CHAMPS Presentation School Based Services Liaison meeting February 25, 2010 Lisa Trumbell, Provider Liaison Lynn Hicks, Provider Support

2 CHAMPS Replaces old system Functions: Check Eligibility Enter claims on-line (Direct Data Entry) On-line Claim adjustments/voids Status claims

3 835 reporting old HIPAA Format 835 now reporting on the correct HIPAA Format: 4010X091-A1 Unique Identifier not reporting or reporting inconsistently on the 835. Defect filed 2/22/10.

4 CHAMPS Eligibility Benefit Plan should = MA (Medicaid Fee- For-Service) If Eligibility returns: MC-MA (Medicaid Managed Care) it must also have MA listed as a separate Benefit Plan

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6 Eligibility Duplicate ID’s: MPHI will post a toll free number on www.mihealth.org www.mihealth.org Toll Free number customer service representatives specialized in assisting w/ duplicate ID corrections

7 Updates: Issues: 1)V2799 Vision Services Misc rejecting for Prior Auth. Required. This code does not Require PA. Scheduled for 2/26/10 release. 2) Reason code 31: Patient Cannot be identified as our insured. - Benefit plan & Procedure code identification issue. Procedure excluded from Benefit plan in error. Claims processing to correct as this edit appears.

8 Updates Issues: 3) Diagnosis code does not support Procedure code: Affected all codes. Claims pending. Status: Corrected. Dx codes now loaded. MDCH to release the pended claims.

9 Updates: Issues: 4) Reason Code 18 Exact Duplicate Resolution: Inquire on claim in CHAMPS using TCN, click TCN hyperlink, click claim line hyperlink, in show menu select Claim Limit list to view duplicate claim TCN.

10 Updates Issue: 5) Remark Code: 204 Service/equipment/drug not covered under patient’s benefit plan. Resolution: Confirm beneficiary has MA as a benefit plan. Confirm procedure code in SBS fee screen.

11 Updates Issue: 6) T1024 Team Eval. & Management Rejecting incorrectly w/ Reason Code: 204 Status: MDCH reviewing

12 Updates CHAMPS Updates can be found at: www.michigan.gov/mdchwww.michigan.gov/mdch click CHAMPS scroll down to CHAMPS Provider Update Table

13 SBS Training SBS specific billing & CHAMPS training in June, 2010 (Date, location TOB) Navigational Sessions (TOB) Visit: www.michigan.gov/mdch click CHAMPS scroll to Medicaid Provider Trainingwww.michigan.gov/mdch

14 CHAMPS Resources For CHAMPS Navigation issues: CHAMPS Helpline: 1-888-643-2408 or champs@michigan.gov champs@michigan.gov For Billing Questions: Provider Inquiry: 1-800-292-2550 or providersupport@michigan.gov providersupport@michigan.gov


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