1. Review of PCS Billing NC Division of Medical Assistance January 2013

2. 2 NCECSWeb Tool Next slides will present Screen Shots of actual form on Web Tool Web Tool https://webclaims.ncmedicaid.com/ncecs Must have a HP login and password Don’t have a login? Contact HP ECS for login 1-800-688-6696, menu option 1

3. 3 https://webclaims.ncmedicaid.com/ncecs

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8. 8 Do not provide history of

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13. 13 Use the modifier listed in Decision Notice Provider receives from CCME

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15. 15 What Billing Questions are directed to HP? Denials Incorrect or Missing Carolina Access Number Incorrect CPT code Assistance with the Web Tool Request for on site visit

16. 16 RESOURCES HP Enterprise Services (HPES) – Provider Services Toll Free Number: 1-800-688-6696 Division of Medical Assistance (DMA) - http://www.ncdhhs.gov/dma/index.htm Basic Medicaid and NC Health Choice Billing Guide - http://www.ncdhhs.gov/dma/basicmed

17. 17 RESOURCES The Carolina Center for Medical Excellence (CCME) - www.thecarolinascenter.org CCME’s Call Center is available Monday through Friday from 8:00 a.m. – 5:00 p.m. Toll Free Number: 800-228-3365

18. 18 RESOURCES Special Bulletin Dec 2011 http://www.ncdhhs.gov/dma/bulletin/NCECSWebGuide.pdf North Carolina Electronic Claims Submission/Recipient Eligibility Verification Web Tool https://webclaims.ncmedicaid.com/ncecs https://webclaims.ncmedicaid.com/ncecs www.nucc.org Provides a crosswalk of paper CMS 1500 fields to electronic form equivalent fields

19. 19 RESOURCES Place of Service Codes General Bulletin Dec 2005 http://www.ncdhhs.gov/dma/bulletin/pdfbulletin/1205bulletin.p df http://www.ncdhhs.gov/dma/bulletin/pdfbulletin/1205bulletin.p df PCS Limitations or Requirements 5.4.1 Place of Service http://www.ncdhhs.gov/dma/mp/3L.pdf

20. 20 RESOURCES www.cms.gov http://www.cms.gov/medicare- coverage-database/staticpages/icd-9- code-lookup.aspx http://www.cms.gov/medicare- coverage-database/staticpages/icd-9- code-lookup.aspx

21. 21 QUESTIONS?