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Re: Medicare and Medicaid Manuals
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tonhealthcare
Re: Medicare and Medicaid Manuals
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: 202
Feb 10 05 7:04 AM
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My Recent Posts
Hi Chris:
I'm in Pennsylvania (Elkins Park-Montgomery County).
The FI's for PA are:
Part A: Veritus Medicare (Pittsburgh) -
www.veritusmedicare.com
Part B: HGSAdministrators (Harrisburg) -
www.hgsa.com
Yes, the manuals do differ from state to state. This due to Local Medical Review Policy, Demographic specific information, state (healthcare) legislation, direct provider involvement in health issues, and the medical societies.
Thus, the FI information for each carrier has a general basis for information which is the Centers for Medicare and Medicaid Services.
The Pennsylvania Office of Medical Asistance administers Pennsylvania's MA program. Also, you will find Managed Medicaid information on this site.
www.dpw.state.pa.us/omap/...romise.asp
Just an FYI: 90% of Pennsylvania's Medicaid population is enrolled in Managed Care programs contracted to commercial managed care plans.
You can find specific information about the Mediciad Managed Care plans on the payor's website. For example the following companies contract with the state to administer their MA programs:
Keystone Mercy
www.keystonemercy.com
Health Partners
www.healthpart.com
AmeriChoice (owned by UnitedHealth Group)
www.americhoice.com
I hope this information was helpful. If you need anymore help, just let me know.
Viola
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Association News
Medical Billing & Coding Education from the MAB
Continuing Education
Management Advice and Training
Questions Asked More Than Once
Help Wanted - Billing and Coding
Non Billing Talk
The Venting Area (Clean posts please)
Medical Coding and Billing News
Fraud and Abuse
Health Insurance - Provider Contracting
ERISA
Tricare
Workers' Compensation
General Medical Billing Questions
Appeals
Accounts Receivables (A/R)
Refunds
Auto Accident Issues
Medisoft Technical Support
Medical Software Technical Support Questions Other than Medisoft. No Investigation Questions!
General Medical Coding Forum
CPT Coding Questions
HCPCS Coding Questions
ICD-9-CM Coding Questions
Evaluation & Management Coding Questions
Acupuncture Billing and Coding
Ambulance Coding and Billing
Cardiology Coding and Billing
Chiropractic Coding and Billing
Dental Billing and Coding
DME Coding and Billing
Emergency Department Coding and Billing
Family Practice Coding and Billing
Hospital Inpatient and Outpatient Coding
Hospital Billing, Appeals and Collections
Internal Medicine Coding and Billing
Laboratory Coding and Billing
Ophthalmology Coding and Billing
OB-GYN Coding and Billing
Pain Management Coding and Billing
Pediatric Coding and Billing
Podiatry Coding and Billing
Physical Therapy Coding and Billing
Psychiatry Coding and Billing
Radiology Coding and Billing
Surgery Coding and Billing
Neurology Coding and Billing
Urgent Care Coding and Billing
Provider Compliance
Billing Center Compliance
HIPAA
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