Provider Notice Issued 12/05/2019

Date:   December 5, 2019                                                   
 
To:      Long Term Care Facilities - Nursing Facilities (NF), Supportive Living Program (SLP) Providers and provisionally licensed Specialized Mental Health Rehabilitation Facilities (SMHRF)
 
Re:     Update: Patient Credit File Download through the Medical Electronic Data Interchange (MEDI) System
______________________________________________________________________
 
In the Provider Notice dated 04/11/19, Long Term Care (LTC) providers were given instructions for downloading the patient credit file through the Medical Electronic Data Interchange (MEDI) System.
 
This notice is to inform LTC providers that the programming to add two (2) new indicators to the patient credit file has been completed.
 
·         If a resident has been authorized for Provisional Eligibility, a data element in the 100th character will display a “P” indicator.
 
Example: 123456789DOE           JANE     123456789001        20190010000000000086800                 288P
 
·         If a resident has been authorized with a Medicare-only admission, a data element in the 100th character will display an “M” indicator.
 
Example: 123456789DOE           JANE     123456789001       20190010000000000086800                 288M
 
If there is a Medicare-only admission that overlaps the same timeframe as the Provisional Eligibility, the “M” indicator will take precedence over the “P” indicator.
 
The patient credit file is transmitted to the Managed Care Organizations (MCOs) weekly.  It is also available for LTC providers to download via MEDI on a weekly basis.
 
Questions regarding this bulletin may be directed to the Bureau of Long Term Care at
1-844-528-8444.
 
Doug Elwell
Medicaid Director

Notices

 

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