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Medicaid Billing Software for Florida APD Service Authorization and Utilization Management

WATERBURY, Conn., Dec. 12, 2011 /PRNewswire/ — “Therap’s Medicaid billing software, has been approved for ASC X12 version 5010 transactions by HP Enterprise Services, formerly Electronic Data Systems (EDS), the MMIS vendor in Florida.” – said Barry Pollack, Therap’s Business Development Consultant and former HCBS provider in Florida. “This update will allow HCBS/DD Waiver service providers under Florida APD (Agency for Persons with Disabilities) to submit HIPAA 5010 compliant professional claims directly to Florida Medicaid.”

ASC X12 version 5010 is the latest transaction standard. All developmental disabilities providers, will have to transition to HIPAA 5010 by January 1, 2012, as required by the Centers for Medicaid & Medicare Services (CMS).

In addition to producing claims, Therap Medicaid billing software can track claim status and produce remittance reports. The web-based electronic billing system offers flexible options for managing quarterly service authorizations. “With the Florida APD, moving to quarterly service authorizations with the iBudget system, this feature of Therap Electronic Billing will help HCBS/DD Waiver service providers, such as the Florida ARF membership, to maximize service authorization utilization.” – commented Barry Pollack.

For each service outlined in a service authorization, the measuring unit, unit number and unit rate are specified. Flexible options are provided for tracking service authorization expiration dates and remaining balance. Billable units can be generated directly from attendance records, individuals’ service logs and goal tracking data. Therap’s web-based interface allows direct support professionals to record data at the point of service, reducing the likelihood of errors.

Users of Therap Electronic Billing software can create Utilization Management Reports, which show the average usage and remaining balance for particular services. This allows providers to look ahead and make necessary adjustments in service provisions.

Additional reporting features of Therap electronic billing system include reconciliation reports, denial reports and unclaimed reports.

In addition to Florida, Therap’s HIPAA 5010 compliant Medicaid billing software has been approved by MMIS vendors and trading partner service providers in other states including New York and Kansas.

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