Upload
derrick-bruce
View
227
Download
4
Embed Size (px)
Citation preview
How to Use DDEProfessional Billing
for Alternative Care Providers
How to use DDE:Professional Billingfor Alternative Care
• Go to www.medicaid.state.ar.us• Click on “Provider”• Click on “Log on”• Enter the provider’s 9-digit Medicaid
ID number (PIN) as the User ID– The setup password is the provider’s SSN
(will be prompted to change)
• Click the Submit button
How to use DDE:Professional Billingfor Alternative Care
Log On
Once you are logged on, your provider name will appear under “Welcome Back”.
To start a new claim, click on “Professional Claim”.
To void or adjust a previous claim, click on “Professional Claim reversal”.
How to use DDE:Professional Billingfor Alternative Care
Header: Submitter Information
How to use DDE:Professional Billingfor Alternative Care
• Entity Type– Enter person
• Last/Organization Name/First Name– Enter the Provider last and first name
• Electronic Transmitter ID– Enter eight zeroes: 00000000
• Name/Telephone number– Enter your name and phone number,
including area code
How to use DDE:Professional Billingfor Alternative Care
Submitter
How to use DDE:Professional Billingfor Alternative Care
Header: Billing Provider
• Medicaid Provider ID/NPI– Enter the provider’s Medicaid ID number and
leave the NPI field blank
How to use DDE:Professional Billingfor Alternative Care
Billing Provider
How to use DDE:Professional Billingfor Alternative Care
Header: Subscriber Information
• Enter the beneficiary’s information– Last Name– First Name– Middle Name (not required)– Medicaid beneficiary ID number– Address, including City, State, Zip– Birth Date
• Format is MMDDYYYY• If DOB is 01/01/2010, enter 01012010
– Gender
How to use DDE:Professional Billingfor Alternative Care
Subscriber
How to use DDE:Professional Billingfor Alternative Care
Header: Claim Information
• Patient Account Number– 12345
• Place of Service– Place of service - Enter 12
How to use DDE:Professional Billingfor Alternative Care
Claim Information
How to use DDE:Professional Billingfor Alternative Care
Header: Diagnosis Codes
• Principal Diagnosis Information – Enter the primary diagnosis code – Do not include the decimal– Example: If DX is 111.11, enter 11111
• Other Diagnosis Information– Enter additional diagnosis codes if applicable
How to use DDE:Professional Billingfor Alternative Care
Diagnosis Codes
How to use DDE:Professional Billingfor Alternative Care
Services: Add Service to Claim
• Procedure– Enter S5125
• Charge – The dollar amount that you are billing. Using
the Pay Grid that follows, enter the Billing Amount for the hours you worked.
• Quantity– Units of time that you worked. Using the Pay
Grid that follows, enter the Units Worked for the hours you worked.
• Diagnosis Code Pointer– Enter 1
How to use DDE:Professional Billingfor Alternative Care
Add Service to Claim
Pay Grid
Hours Worked(15 min. increments)
Units Worked Billing Amount(Units X $2.43)
15 mins 1 $2.43
30 mins 2 $4.86
45 mins 3 $7.29
1 hr 4 $9.72
1 hr, 15 mins 5 $12.15
1 hr, 30 mins 6 $14.58
1 hr, 45 mins 7 $17.01
2 hrs 8 $19.44
2 hrs, 15 mins 9 $21.87
2 hrs, 30 mins 10 $24.30
2 hrs, 45 mins 11 $26.73
3 hrs 12 $29.16
3 hrs, 15 mins 13 $31.59
3 hrs, 30 mins 14 $34.02
How to use DDE:Professional Billingfor Alternative Care
Use this table to complete your AAS-9559. Find the hours you work at one time. Then enter the Units Worked and the Billing Amount on the AAS-9559.
Example: You work 2 hours and 15 minutes one day. On the AAS-9559, enter 9 units worked and $21.87 for the billing amount.
Pay Grid
How to use DDE:Professional Billingfor Alternative Care
Hours Worked(15 min. increments)
Units Worked Billing Amount(Units X $2.43)
3 hrs, 45 mins 15 $36.45
4 hrs 16 $38.88
4 hrs, 15 mins 17 $41.31
4 hrs, 30 mins 18 $43.74
4 hrs, 45 mins 19 $46.17
5 hrs 20 $48.60
5 hrs, 15 mins 21 $51.03
5 hrs, 30 mins 22 $53.46
5 hrs, 45 mins 23 $55.89
6 hrs 24 $58.32
6 hrs, 15 mins 25 $60.75
6 hrs, 30 mins 26 $63.18
6 hrs, 45 mins 27 $65.61
7 hrs 28 $68.04
7 hrs, 15 mins 29 $70.47
7 hrs, 30 mins 30 $72.90
7 hrs, 45 mins 31 $75.33
8 hrs 32 $77.76
How to use DDE:Professional Billingfor Alternative Care
Services: Service Date/NDC Info
• Service Date Period (first day worked)– Enter the From and To date of service – (1
day) – same date– Format is MMDDYYYY – If the date of service is 1/1/2010, enter
01012010– Click Add
How to use DDE:Professional Billingfor Alternative Care
Services: Service Date/NDC Info
Services: Adding the Service
How to use DDE:Professional Billingfor Alternative Care
• Once you click the Add button, it will add your service to the top of the screen
• Once you have added the service, you can add a second service, third service, etc.
• Click Submit
How to use DDE:Professional Billingfor Alternative Care
Adding Service (Additional Days) on Claim/Submit Claim