TCM Powerpoint Presentation - Ubhonline.com

More documents

Recommendations

Info

Dispute resolution process • Member may contact Medica Behavioral Health regarding second opinion. • Members have the right to appeal health plan decisions • Members may appoint a provider as their representative to appeal • Providers may also dispute adverse determinations Confidential 8
Billing Procedures • Submit claims electronically with AUC coding, add modifiers TF and TG for intermediate and <strong>com</strong>plex intensity • Use any clearinghouse to bill Medica electronically. Medica’s payer ID is 94265. Providers without a current electronic data interface (EDI) vendor may use the EDI vendor IGI-USA to submit claims electronically at no cost. Registration for this service can be found at www.mneconnect.<strong>com</strong>. • Call the clearinghouse if claim submission was rejected or MBH indicates no claim received. Confidential 9
Page 1 and 2: Targeted Case Management Medica Beh
Page 3 and 4: Medica Behavioral Health - MH Targe
Page 5 and 6: Determining MH-TCM Eligibility •
Page 7: New TCM referrals • MBH staff wil
Page 11 and 12: Contracting Process • UBH is esta
Page 13 and 14: Websites • www.ubhonline.com (res

TCM Powerpoint Presentation - Ubhonline.com

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?