Medical Billing Forum

HIPAA => HIPAA => Topic started by: Alec on November 02, 2017, 02:05:38 PM

Title: MESAV Type Programs
Post by: Alec on November 02, 2017, 02:05:38 PM
Hi!
I'm working with the verification system but I'm not quite sure everything is correct there. Got the question:

1. Does anybody get info or a manual which medicaid's programs of TX cover "Room & Board" and "Coinsurance"?
Let's say I get a message from MESAV: 14 MAO, SSI RELATED, R, B. or 57 MQMB (MAO, SSI RELATED) R.

Thank you!
Title: Re: MESAV Type Programs
Post by: Michele on November 02, 2017, 08:00:55 PM
I am not familiar with Texas MESAV but your question is very unclear.  If you clarify what you are asking someone may be able to help.
Title: Re: MESAV Type Programs
Post by: Alec on November 03, 2017, 05:38:55 AM
I got this message: https://ibb.co/fuyOhb (https://ibb.co/fuyOhb) from the verification system that a patient is covered by this program.
I'm not sure that this program: 57 MQMB (MAO, SSI RELATED) covers "Co-Insurance" and doesn't cover "Room and Board".
Is there a way/a manual to check it out?

Thanks!
Title: Re: MESAV Type Programs
Post by: Michele on November 03, 2017, 06:34:09 AM
MQMB stands for Medicaid Qualified Medicare Beneficiary. Most MQMB members are qualified due to SSI.  What benefit are you wondering if that covers?

I have never used the verification system and I tried to look up those codes on the MESAV system but I didn't have any luck.  Have you tried calling TX Medicaid and asking someone to either walk you thru it or explain what those codes mean?
Title: Re: MESAV Type Programs
Post by: Alec on November 03, 2017, 11:42:40 AM
Struggle to clarify it covers "Room and Board" and "Coinsurance" for SNFs. No luck in this.

Bumped into this table https://www.dads.state.tx.us/providers/communications/2000/letters/attachments/CMS2000-08ATT3.html (https://www.dads.state.tx.us/providers/communications/2000/letters/attachments/CMS2000-08ATT3.html) but I can't understand how to read the table...

Title: Re: MESAV Type Programs
Post by: Michele on November 03, 2017, 02:19:24 PM
I looked at that chart as well and wasn't able to find any of the codes you mentioned in the original post.  That is why I would call to see if someone can't clarify or point you to the right location to find out.