Greetings Iowa Therap User Community!
As we wait for CMS to rule as to whether or not the Iowa Medicaid Modernization initiative is a “GO” for March 1st, Heather Thornton, Therap Billing Specialist, has asked that I share the following regarding agency preparation…
In order to process claims via Therap for the Iowa MCO’s, clearinghouse enrollment is required. Therefore, if Iowa providers using Therap’s Billing Plus module want to send me their NPI, EIN and address information for enrollment into the clearinghouse, I can enter that information now. Please send ALL of your NPI numbers.
Send this information to email@example.com .
Upon receipt and after I enter this information on your behalf, the agency will have the capability to submit claims to the Iowa MCO’s via Therap.
In order to obtain your ERA (Electronic Remittance Advice) for AmeriHealth, there is a pre-enrollment form that must be completed by the agency. If not done so already, please request this form when you send your NPI, EIN information for Amerihealth to me. I will then send you the form that needs to be completed. In turn, you must complete the form and send it to the listed address for Amerihealth.
As you are aware, IME has stated that they will be paying all Iowa Magellan claims for the service dates starting on and after 1/1/16. To make sure you are able to bill within Therap during this transition time, your funding source listed on the Magellan Service Authorizations will need to be changed to IME.
If you have already generated Iowa Magellan claims, you will need to create a new Service Authorizations for the Iowa Magellan claims and replace the funding source with IME in order for them to be processed.
AGAIN – please wait to expire current service authorizations until further notice.
As stated in previous communications, this is all predicated on whether or not CMS approves the Managed Care initiative for Iowa and the new 3/1/16 start date.
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 (firstname.lastname@example.org) 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.