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Idaho MMIS Provider Handbook General Billing Instructions Table of Contents 1. Section Modifications .. 1. 2. General Billing Information .. 8. Online Portal Access .. 8. Participant Responsibility .. 8. Co-payments .. 8. Share of Cost (SOC) .. 9. Medicaid Billing Policies .. 10. Dental .. 10. Hospice Participants .. 10. Interpretive Services .. 11. 340B Pharmacy Billing .. 11. Prior Authorization (PA) .. 11. Provider Licensing .. 15. Service 15. Telehealth Services .. 16. Wellness Exams .. 16. Timely Filing Limit .. 17. Documentation to Support Timely 17. Participant Retroactive Eligibility .. 17. Provider Retroactive Eligibility .. 18. Medicare Processing .. 18. Third Party Insurance .. 19. Prior Authorization .. 19. Adjustments of Paid or Denied Claims .. 19. 19. Idaho Medicaid Claim Standards .. 19. National Correct Coding 19. Diagnosis Codes .. 22. Participant Billing Information .. 22. Provider's Billing 23. Billing Procedure for Date Spanning .. 24. Determining How to Bill Units for 15-Minute Timed Codes.
E Garibovic 63.1 2.3.5 Prior Authorization (PA) Replaced RMS with BLTC. 10/24/18 W Deseron D Baker ; E Garibovic 63.0 All Published version 09/05/18 TQD
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