My larger questions are about how to figure out which Medicaid carrier a patient has and whether the plan is fee-for-service or a managed care organization (which I understand sometimes require preauth). NYS Dept. of Health's website says that NY has both both kinds of plans. This seems important since I've had to fix a few situations where payment was denied for prior auth by a carrier that only handled the MH benefits. Do I just use the MEVS call line? My billing software offers 4 different Medicaid plan options and I have no idea how to determine that information for each Medicaid patient.
I normally check benefits and eligibility, but I don't know how to do that for Medicaid. I figured it out for Medicare, but I'm not sure if MEVS is the equivalent call line for Medicaid. Compounding this is that I don't know if the provider participates with Medicaid (I've asked her to let me know), so I don't have her MMIS to use if I were to call the MEVS line to experiment.
Do you have access to EPACES? That will also be a huge help.. You can apply for access as a billing service.