REIMBURSEMENT
MEMORANDUM
2004-002 – MH Case
Management/Medicaid Billing Monthly Verification
Issued: 06/07/04
Appendix B of the Reimbursement Policies and Procedures
Manual has been established to file memoranda issued by Central Reimbursement
throughout the year, and each memo will be assigned a number. These memos will also be available on the
intranet. Please do not hesitate to
contact anyone in Central Reimbursement if you have any questions.
Beginning with March 1, 2004 dates of service, clinics will
be required to generate reports in CMHC that detail monthly billing for Mental
Health Case Management, and submit a list of consumers who were Medicaid
eligible during the month but were not billed to Medicaid. This list will be submitted each month to the
Division Director and Central Reimbursement.
Central Reimbursement will e-mail clinical managers and
support staff as notification each month that the case management billing has
been completed. Clinic staff will then
generate reports in CMHC summarizing Mental Health Case Management billing for
their clinic. Support staff will
generate three reports for their respective clinics: (1) Saved list of consumers who received
billable case management activity during the month; (2) Report of Medicaid
billing for case management for the month; (3) Report of self-pay billing for
case management for the month
The reports will be generated from a menu item in CMHC, and
detailed instructions for generating these reports are attached. Once the reports are generated, they should
be compared to a master list of Case Management consumers maintained at each clinic
to determine which Medicaid consumers were not billed for the month. Those consumers should then be listed on the
MH Case Management Monthly Follow-up spreadsheet with an explanation of why no
billing occurred, and submitted via e-mail to the Division Director and Central
Reimbursement.
Attached to this Reimbursement Memo are the following:
MH
Case Management Monthly Follow-Up Worksheet (See Appendix A)
Instructions
for Completing the MH Case Management Monthly Follow-Up Worksheet (See Appendix
A)
If you have any questions concerning these changes,
please contact Ann Thomas in Central Reimbursement.