Cov lus nug uas nquag nug: Medi-Medi Billing
Rov qab mus rau MedCCC lub vev xaib
Nqe Lus Nug: Yog tias tus neeg tau txais txiaj ntsig Medi-Medi tau txais cov kev pab cuam nyob rau hauv tus neeg mob thiab cov kev pabcuam Crisis Stabilization tsis pub dhau 72 teev tom qab tus neeg mob nyob hauv, Medicare xav kom tag nrho cov kev pabcuam no tau txais los ntawm ib daim ntawv thov (837I). Kev them nyiaj rov qab Medicare tsis raug suav nrog. MHP tau them tib lub Diagnostic-Related Group (DRG) tus nqi seb puas muaj kev kub ntxhov los yog tsis muaj kev ruaj ntseg thaum muaj kev kub ntxhov tshwm sim hauv 72 teev ntawm tus neeg mob nyob hauv. MHP yuav tsum siv Medicare cov nyiaj them rov qab rau Medi-Cal li cas?
- Teb: MHP yuav tsum thov Medi-Cal rau lub tsev kho mob cov kev pab cuam hauv tsev kho mob ntawm 837I thiab Crisis Stabilization ntawm 837P. Tag nrho cov nyiaj them rov qab Medicare yuav tsum raug siv rau Medi-Cal 837I rau cov kev pab cuam hauv tsev kho mob.
Nqe Lus Nug: Yog tias tus neeg tau txais txiaj ntsig Medi-Medi tau txais kev pabcuam Crisis Stabilization uas tsis muaj kev pabcuam hauv tsev khomob, lossis tsis muaj cov kev pabcuam hauv tsev khomob hauv 72 teev thiab MHP thov qee qhov ntawm DMH lees paub tias muaj teebmeem teebmeem rau Medicare (xws li kev pabcuam kws khomob), MHP yuav siv li cas Medicare cov nyiaj rov qab rau Medicare?
- Teb: MHP yuav tsum thov Medi-Cal rau qhov sib npaug ntawm qhov kev thov uas tsis tau them los ntawm Medicare rau Crisis Stabilization ntawm 837P. MHP yuav tsum xa Medicare cov nyiaj them rov qab raws li Kev Sib Koom Tes ntawm Cov Nyiaj Pab (COB) cov nyiaj kom nws tuaj yeem siv rau SDMC cov nyiaj them.
Nqe Lus Nug: Puas yog tus txheej txheem (HCPCS) code "H2017" siv rau txhua qhov kev pabcuam tshwj xeeb rau kev puas siab puas ntsws raws li Tsoom Fwv Teb Chaws Rehabilitation State Plan Option ("Rehab Option")?
- Teb: Tsis yog H2017 tsuas yog siv los thov kev pabcuam kev pabcuam Kev Khomob raws li Kev Pabcuam Kev Puas Hlwb. Rehabilitation yog ib qho kev pab cuam nyob rau hauv Mental Health Services uas tsis yog Medicare them rov qab txawm hais tias nws muab qhov twg los. Qee qhov “Kev Xaiv Kho Kho Kho Kho Dua Tshiab” nyob rau hauv California Txoj Kev Npaj Kho Mob Medicaid yog Medicare them rov qab.
Nqe Lus Nug: Yuav ua li cas them nqi rau cov kev pabcuam hauv zej zog?
- Teb: Cov kev pabcuam tshwj xeeb rau kev puas siab puas ntsws muab rau hauv zej zog tsis yog Medicare them rov qab thiab yuav tsum tau thov ncaj qha rau Medi-Cal. Thaum ib qho kev pabcuam raug muab rau hauv "cov zej zog" thiab tsis muaj lwm qhov chaw tsim nyog ntawm kev pabcuam code siv, qhov chaw ntawm kev pabcuam code yuav tsum tau qhia tias yog 99 (lwm yam) thiab tus hloov kho "HQ" yuav tsum tau siv nrog cov txheej txheem H2010 thiab H2015 los qhia tias qhov kev pabcuam tau muab rau hauv zej zog. Medi-Medi thov nrog qhov chaw muab kev pabcuam code 99, tab sis yuav tsis muaj qhov hloov pauv uas yuav tsum muaj kev sib koom tes ntawm cov txiaj ntsig. Ib yam li ntawd, Medi-Medi thov rau cov txheej txheem code H2010 lossis H2015 cov kev pabcuam nrog tus txheej txheem hloov kho “HQ” uas tsis suav nrog qhov chaw pabcuam 99 yuav raug tsis lees paub.
Nqe Lus Nug: Dab tsi yog qhov kev pabcuam hauv xov tooj thiab yuav ua li cas thiaj li sau nqi?
- Teb: Cov kev pabcuam hauv xov tooj txawv ntawm cov kev pabcuam telemedicine. Cov txiaj ntsig ntawm Telemedicine yog Medicare them rov qab thaum muab los ntawm lub tsev kho mob los ntawm kev sib tham lub suab thiab pom kev sib cuam tshuam ntawm tus kws kho mob thiab tus neeg siv khoom thiab thaum muab rau hauv thaj chaw tshwj xeeb, tsim nyog. Cov kev pab cuam muab los ntawm telemedicine yuav tsum tau thov rau Medicare ua ntej Medi-Cal tshwj tsis yog muaj lwm qhov kev zam rau Medicare ua ntej thov
Nqe Lus Nug: Qhov chaw pabcuam "03" (School) txhais li cas?
- Teb: Ib qho chaw uas nws lub hom phiaj tseem ceeb yog kev kawm.
Nqe Lus Nug: Qhov chaw ua haujlwm "15" (Mobile Unit) txhais li cas?
- Teb: Ib lub chaw/chaw uas txav los ntawm qhov chaw mus rau qhov chaw thiab nruab los muab kev tiv thaiv, kev tshuaj ntsuam xyuas, kev kuaj mob, thiab / lossis kev kho mob.
Nqe Lus Nug: Yuav ua li cas cov kev pabcuam "Plan Development" nyob rau hauv "Kev Pabcuam Kev Puas Siab Puas Ntsws" yuav raug them nqi rau Medi-Medi kev thov?
- Teb: Plan Development yog ib qho kev pab cuam nyob rau hauv Kev Pabcuam Kev Puas Hlwb uas tsis yog Medicare them rov qab txawm tias nws muab rau qhov twg, lossis leej twg muab nws. Thaum thov cov kev pab cuam Plan Development nyob rau hauv Mental Health Services, Mental Health Plans (MHPs) tej zaum yuav siv tus txheej txheem code H0032 los sau Medi-Cal ncaj qha rau cov neeg siv Medi-Medi.
Nqe Lus Nug: Yuav ua li cas cov kev pabcuam "Kev Ntsuam Xyuas", "Kev Kho Mob", thiab "Collateral" nyob rau hauv "Kev Pabcuam Kev Puas Hlwb" yuav raug them nqi rau Medi-Medi cov ntaub ntawv?
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Teb: Cov no yuav tsum tau thov rau Medicare ua ntej Medi-Cal, siv tus txheej txheem code H2015, tshwj tsis yog muaj kev zam rau Medicare cov nqi them (piv txwv li, kev pabcuam yog muab hauv xov tooj lossis hauv zej zog, nws yog muab los ntawm Medicare uas tsis yog Medicare. tus kws kho mob uas tau them rov qab, lossis hauv qhov chaw uas tsis yog Medicare them rov qab tau txais kev pabcuam).
Txuas mus rau lwm nplooj ntawv MedCCC