IMA
IMA Admin Update
APGs Week 2 - continued
January 12, 2012


IMA Admin Update

Here is a quick mid-week update on APG and 5010 billing.

We have learned that Medicaid is encountering serious problems processing the APG claims. If you get denials or unexpected payment amounts, do not assume you have sent the claim incorrectly.

Here are the issues we have been told about.
  • All SED Billing is all being denied
  • All SSI carve out billing is being denied
  • A $3 copay is being deducted from all payments
  • Payment rate was set incorrectly set using the 75/25 blend instead of the 50/50 blend

I am sure you will hear more on this directly from Medicaid and OMH very soon.  

Here at IMA we continue to dedicate our resources to help each of you through this transition. Please keep us informed of anything you encounter or learn. We continue to enhance the APG and 5010 billing modules to resolve open issues and add new features.   

 

Barry Samel 

 

 

 

 

 

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