TESTING OF MCO ELECTRONIC LINKS FOR THERAP BILLING COMPLETE!

Iowa Providers that utilize Therap’s Billing Plus functionality (the ability to submit claims directly from the platform), please find below our current progress.Medicaid-Managed-Care-Square

Therap Billing Specialist, Heather Thornton, is pleased to share this update…

Therap has completed their testing with the 3 current MCO’s…

  • Amerigroup Iowa, Inc.
  • AmeriHealth Caritas Iowa, Inc.
  • UnitedHealthcare Plan of the River Valley, Inc.

….and test claims have gone through the clearinghouse with no issues. The funding sources are now available in Therap.

This is great news as it means that when the MCO’s do GO LIVE, Therap Billing functionality will be ready.

NOTE: As we are all aware, Wellcare was disqualified from the Iowa Medicaid Modernization initiative on 12/18/15.   As of 12/22/15, Wellcare was/is appealing the decision. While Therap will keep that link available, testing will not be done until a decision on the appeal is announced.

NEXT STEPS
While this is a relatively small task, you can create the funding sources in your Therap platform for the 3 current MCO’s and attach the applicable “Payer”. Please see steps below:

  • Go to Admin Tab -> Billing section
  • From “Funding Source”, select “New”.
  • Input the applicable MCO information. (Red asterisk = Required)
  • Select applicable “Payer” option from the pull down menu in the Electronic Billing section (near bottom of the page).
  • Click on “Save”.
  • Complete the process for the remaining MCO’s.

AGAINplease wait to expire your current service authorizations until further notice.

This is all predicated on whether or not CMS approves the Managed Care initiative for Iowa and the new 3/1/16 start date. From the available information, CMS is forecast to return to Iowa in mid-February to make that determination.

THERAP IOWA PROVIDER BILLING WEBINAR BEING PLANNED.

Once we have definitive information on the start date for the Iowa Medicaid Modernization initiative, I plan to hold an instructional webinar for Iowa Providers using the Billing Plus module and explain how to move your current Service Authorizations to the new MCO funding sources and other preparation tasks. More information regarding this webinar will be shared when available.

As always, please feel free to contact me (heather.thornton@therapservices.net) if you have any questions specific these changes in the Billing Plus module. We will keep you updated on the progress as we want this to be an easy transition.