Medical Billing Forum

Billing => Billing => Topic started by: Pay_My_Claims on August 28, 2009, 01:41:00 PM

Title: NC Medicaid Providers
Post by: Pay_My_Claims on August 28, 2009, 01:41:00 PM
Please inform anyone you are billing NC medicaid with of the following changes.

Attention:  All Providers
Electronic Claims Submission and Fund Transfers

As a cost saving measure and to increase efficiency, the N.C. Medicaid Program will require all providers to file claims and receive payments electronically.  The date for the implementation of this requirement and further instructions including a list of exceptions for electronic claims submission will be published in the July General Medicaid Bulletin.  This bulletin serves as a preliminary notice so that providers may begin to make the necessary business changes to accommodate this requirement.  If youare already filing claims and receiving payments electronically, no further action is needed.

Electronic Claims Submission
Providers who did not complete an Electronic Claims Submission Agreement at the time of their enrollment must now complete and submit an Electronic Claims Submission Agreement. The Electronic Claims Submission Agreement must be submitted and approved prior to submitting claims electronically regardless of whether you are submitting your claims through a clearinghouse, with software obtained from an approved vendor, or through the NCECSWeb Tool. Once notification of approval is received, providers must contact the EDS Electronic Commerce Services Unit (1-800-688-6696 or 919-851-8888, option 1) to obtain a logon ID and password for electronic claims submission.

Group providers must submit the name and Medicaid Provider Number for each individual provider affiliated with their group for whom they will be submitting claims using their group provider number.  This is required even if there is only one provider in the group.  The Electronic Claims Submission Agreement for the group must be signed by each individual provider, which authorizes the group to use the individual's National Provider Identifier to bill Medicaid for services provided.