Virginia Regulatory Town Hall
Agency
Department of Medical Assistance Services
 
Board
Board of Medical Assistance Services
 
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12/3/21  9:34 am
Commenter: Susan Bergmann, LCSW, MBA - Director of QI at NCTR

ARTS Manual Chapter V - Questions, Comments, Concerns
 

The feedback for Chapter 5 is as follows:

  • On page 5 it reads “Providers should refer to the MCO or the BHSA for information on services that allow span billing.” Is it possible for all MCOs and BHSA to have the same services that allow span billing?
  • Page 10 begins the review of Timely Filing. Is it possible for all MCOs and BHSA to have the same timely filing requirements for all Medicaid services to improve ease of billing? In addition, other payers can take longer than the timely filing limit for the MCOs that do not allow 12 months which we believe bolsters the argument for the need for standardization of timely filing limit.
  • On page 15, the table referencing Per Diem reimbursement mentions “non-psychotherapy interventions.” We are seeking a clear definition of what this term entails.
  • On page 15, the second bullet reads “Other medical and psychological professional services including those furnished by licensed mental health professionals and other licensed or certified health professionals;” We request a clear definition of “psychological professional services.” Does this mean individual and group can now be billed if performed by a licensed person?
  • On page 15, the list of services that may be billed separately includes “Non-Emergency Transportation services including transportation to appointments and Family Engagement;” Does this mean we may bill for transportation provided by our staff and/or transportation provided by 3rd party that we pay for? How would we go about billing for this? Is there a formal code or procedure?
CommentID: 116756