Mental Health Guidelines and Billing Practices - Indiana

Mental Health

Guidelines and Billing

Practices

HP Provider Relations

July 2011

Agenda

¨C Session Objectives

¨C Outpatient Mental Health

¨C Medicaid Rehabilitation Option (MRO)

¨C Risk-Based Managed Care (RBMC)

¨C Eligibility Inquiry

¨C Web interChange and CMS-1500 Billing Guidelines

¨C Helpful Tools

¨C Questions

2

Mental Health Guidelines and Billing Practices

July 2011

Objectives

At the end of this presentation, providers will understand the

following:

¨C Outpatient coverage requirements

¨C MRO services

¨C Meaning of rolling 12-month period

¨C Role of the health service provider in psychology (HSPP)

¨C Managed care carve-in

¨C How to verify member eligibility

¨C How to submit claims via the Web interChange and the CMS1500 claim form

3

Mental Health Guidelines and Billing Practices

July 2011

U d

Understand

t d

Outpatient Mental Health

Mental Health

¨C The Indiana Health Coverage Programs (IHCP) under the direction of

the Indiana Administrative Code (IAC) 405 IAC 5-20-8 reimburses for

outpatient

t ti t mental

t lh

health

lth services

i

when

h provided

id d b

by:

? Licensed physicians

? Psychiatric hospitals

? Psychiatric wings of acute care hospitals

? Outpatient mental health facilities

? Licensed psychologists with the HSPP designation

5

Mental Health Guidelines and Billing Practices

July 2011

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download