New Jersey Medicaid Billing Manual 2018



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New Jersey Medicaid Billing Manual 2018

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Presentation – State of New Jersey

www.nj.gov

Oct 19, 2016 The final rule is the first update to Medicaid and CHIP managed care regulations
in over a decade. • This final rule advances the agency's mission of better care,
smarter spending, and healthier people. • The health care delivery landscape
has changed and grown substantially since 2002. – In 1998, 12.6 …

Projected Timeline for the Shift to Fee-for-Service – State of New

www.nj.gov

New Jersey Department of Human Services. Division of Developmental
Disabilities www.nj.gov/humanservice/ddd. Projected Timeline for the Shift to Fee
-for-Service: Information for Individuals and Families. The Division will notify
individuals as they are identified to enroll into fee-for-service. Other than ensuring
the NJ CAT.

NJ FamilyCare Expansion and Provider FAQs – State of New Jersey

www.nj.gov

Mar 13, 2014 Medicaid will move from Program Status Code … January 2018: 94%. • January
2019: 93%. • January 2020: 90%. Increased Income Limits. • 133% of the Federal
Poverty Level for most NJ Residents … Download a packet from the New Jersey
NJ Medicaid Management Information System (NJMMIS) web.

NJ FamilyCare Dental Update – State of New Jersey

www.nj.gov

Medicaid Adults. Source: NJ Shared Data Warehouse, accessed 3/31/17. Notes:
Amounts shown are dollars paid for dental services through one of the following
service …. starting with contracts on or after July 1, 2017. Compliance with CHIP
provisions beginning with the state fiscal year starting on or after. July 1, 2018.

SE1128 – CMS.gov

www.cms.gov

Dec 8, 2017 QMBs cannot elect to pay Medicare cost-sharing but may need to pay a small
Medicaid copay in certain … Look for new information and messages in CMS'
HIPAA Eligibility Transaction System. (HETS) (effective November … bad debt,
refer to Chapter 3 of the Provider Reimbursement Manual (Pub.15-1).

Provider Enrollment – CMS.gov

www.cms.gov

Sep 1, 2017 MAC mail room. • Manual data entry. Intake. 2. PECOS. Processing, Screening. &
Verification. 3. Pre Screening. ▫ signed + dated. ▫ app fee (or waiver) ….. CMS-
2390 starts JUL 2018. Medicaid Managed Care network providers that furnish,
order, refer or prescribe must: enroll in Medicaid. Reduces fraud. 1.

2017-2018 Influenza (Flu) Resources for Health Care … – CMS.gov

www.cms.gov

Sep 21, 2017 new year. • Remember to immunize yourself and your staff. BACKGROUND. The
Centers for Medicare & Medicaid Services (CMS) reminds health care … CPT
90673. $40.613. 8/1/2017-7/31/2018. CPT 90674. $24.047. 8/1/2017-7/31/2018.
CPT 90682. $46.313. 8/1/2017-7/31/2018 (New code). CPT 90685.

Application print HHS NJ.1479.R00.01 – Apr 01, 2016 – Medicaid.gov

www.medicaid.gov

Apr 1, 2016 2016 through March 31, 2018, the federal medical assistance percentage (FMAP
) rate applicable to such payments shall be equal to 90 percent. … Transmittal
Number: NJ-16-0001 Supersedes Transmittal Number: NJ-14-0014 Proposed
Effective Date: Apr 1, 2016 Approval Date: Attachment 3.1-H Page …

One-Time Notification – CMS.gov

www.cms.gov

Aug 4, 2017 Transmittals through Transmittal Number 1997, dated January 5, 2018, are
included in this update. As new transmittals are issued, they will be identified on
this page. FILE. COMM. DATE. SUBJECT/SUMMARY OF …… Medicaid Services (
CMS) Medicare. Secondary Payer (MSP) Data Match. Program from …

Health Care – Oregon State Legislature

www.oregonlegislature.gov

Jul 18, 2017 Oregon, Medicaid billing for school health services consists of Medicaid
administrative claiming …. National awareness, new guidelines, and
recommendations have emerged that seek to inform coaches, athletic trainers,
and …. the Legislative Assembly no later than September 15, 2018. Oregon Laws
 …

GAO-17-173, MEDICAID: Program Oversight Hampered by Data …

www.gao.gov

Jan 6, 2017 MEDICAID. Program Oversight Hampered by Data. Challenges, Underscoring
Need for Continued. Improvements. What GAO Found. GAO found that … identify
billing patterns that indicate inappropriate provider behavior or ensure …. new
and we have designated Medicaid as a high-risk program since.

Round 2 CPC+ Practice External FAQs – Office of Population Health …

pophealth.health.maryland.gov

Dec 15, 2016 CPC+ Round 2 begins on. January 1, 2018. CPC+ consists of five performance
years, per the table below. CMS expects practices to participate for … New Jersey
: Amerigroup New Jersey, Inc., Horizon BlueCross BlueShield of New Jersey, …..
These incremental requirements will guide practices through.

DSRIP APM Roadmap – New Hampshire Department of Health and …

www.dhhs.nh.gov

1 | Page. New Hampshire's Building Capacity for Transformation Section 1115(a)
. Medicaid Research and Demonstration Waiver. DSRIP Alternative Payment
Models Roadmap. For. Year 2 (CY2017) and Year 3 (CY2018) …

3M All Patient Refined Diagnosis Related Groups (APR DRGs)

www.forwardhealth.wi.gov

Oct 17, 2016 Grouping and reimbursement for managing expected reimbursement …. For
example, hospital admissions for a typical Medicaid population are composed of
… Medicare. DRG Updates. New York AP-DRG. Expansion. Yale DRG
Refinements. Initial Development of All Patient Refined DRGs (APR. DRGs) …

Weekly Review – Illinois Comptroller

illinoiscomptroller.gov

Staff report on the Medicaid Managed Care Organization RFP (2018-24-001) –
May 2, 2017. Since 2011, Illinois has sought to migrate its Medicaid beneficiaries
into a risk- based, managed care organization (MCO) system. This integration
has not always progressed smoothly, with doctors, patients, and healthcare …

EXHIBITS Contract/RFP No. YH18-0001 EXHIBIT A … – ahcccs

www.azahcccs.gov

Jan 17, 2017 the Submission Requirements outlined in RFP Section H: Instructions to Offerors.
OFFEROR'S …. implementing a me* member empowerment culture. me* was
recognized and published by the Medicaid Health Plans …. 2018, to become a
statewide D-SNP covering all 15 counties in Arizona. We filed a …

department of health care policy and financing fy 2017-18 joint …

leg.colorado.gov

Dec 14, 2016 Medicaid and Children's Basic Health Plan (CHP+) programs as a result of the
new federal administration. … by FY 2018-19 a full 75 percent of clients with a
serious and persistent mental illness (SPMI) or ….. change the calculation of legal
services appropriations as well as the monthly billing system for.

Medicare Supplement Shopper's Guide – SC Department of Insurance

www.doi.sc.gov

2017 Shopper's Guide …. ductible, coinsurance or copay- ment – if the plan
allows balance billing. Refer to plan details. Medicare with Medigap vs. Medicare
Advantage Comparison. Medigap or Medicare Supplement Insurance …. Don't
drop a current insurance policy until you have your new coverage. Don't buy
more than …