July 4th, 2008 is a designated state holiday to recognize Independence Day. Due to the state offices being closed, the billing deadline for Behavioral Health Providers will be moved to Monday the 30th at 5:00 pm. For all other providers, billing deadline will be Tuesday July 1st at 5:00 pm. Please contact Provider Relations for questions, 888-483-0793.
Provider Alert:
As of 12:01am Friday, May 23, 2008 NPI will be REQUIRED for ALL WV Medicaid claims*. This rule applies to claims submitted via clearinghouse, upload files, direct data entry on the Web Portal and paper. If you submit claims without an NPI your claims will be returned unprocessed. Please remember if you are using the PATIENT DEFAULT MANAGEMENT ROSTER you will need to edit the Provider screen. You will need to delete the WV Medicaid Provider number or numbers and enter your applicable NPI number or numbers. If your NPI is a one to many you will need to also enter your taxonomy and 9 digit zip code. If you have questions about billing your electronic claims using your NPI numbers please contact the Unisys EDI Help Desk. When entering the PAAS, Referring and Attending provider numbers you will continue to use the West Virginia Medicaid Provider Number. If you have questions about making sure your NPI is on file with Unisys you may contact the Enrollment Department, both can be reached at 1-888-483-0793. *This does not apply to atypical providers, i.e. non emergency transportation is not required to use NPI. Note to Nursing Home Providers: Please make sure you bill with your NPI numbers when you submit your claims next month.
WV MEDICAID PHARMACY PRESCRIBER NPI DEADLINE EXTENDED TO AUGUST 13TH, 2008 West Virginia Medicaid Pharmacy Providers:
The deadline for submission of Prescriber NPI on WV Medicaid POS claims has been extended until August 13th, 2008. Either the Prescriber NPI or DEA number may be submitted as the Prescriber ID until then. If you are already successfully submitting the NPI Prescriber number, please continue to do so.
As of August 13th, 2008, the WV Medicaid Pharmacy Program will accept the DEA number as the Prescriber Identifier on paper claims ONLY. NPI will also be accepted as the Prescriber Identifier on paper claims after that date.
As of tomorrow, May 23rd, 2008, claims that are submitted without the Prescriber NPI will receive the following text response:
7238W:INVALID PRESCRIBER - NPI REQUIRED AFTER Aug 13 2008
If you receive this text message, this means that we are NOT receiving the Prescriber NPI from your pharmacy. Many pharmacists have told us that they believe that they are submitting the Prescriber NPI but their software is still forwarding the Prescriber DEA number on their claims. As of tomorrow, May 23rd, 2008, if you receive the above mentioned text message from WV Medicaid, you should contact your desktop software vendor for assistance.
NPI Update:
As of 5/23/08 providers must bill with an NPI in the billing and, if appropriate, the rendering provider fields on paper and electronic claims. This is not required for the "atypical providers" which are: Homemaker and Personal Care providers that do NOT bill for RN assessments; and Multi-passenger vans. Claims containing NPI and the Medicaid legacy number will not be rejected at this time. NPIs are not required in secondary fields such as referring, admitting, operating, etc. at this time. The Medicaid # is the preferred approval # for PAAS. Please call Provider Relations, Provider Enrollment or EDI help desk at 1-888-483-0793 if you have any questions concerning this requirement.
Change of Ownership Policy Effective June 1, 2008 A change of ownership requires that all parties involved shall collaborate to ensure that services are billed and paid to the correct owner using the correct provider number. The new provider must obtain an enrollment number to participate in the West Virginia Medicaid Program. The effective date of the new owner’s enrollment is determined when the enrollment application is approved by Unisys. Providers are required to submit a complete and accurate enrollment packet 10 days prior to the change of ownership date and inform Unisys of the exact change of ownership to ensure a seamless transition. Services rendered prior to the effective date will not be payable through Medicaid.
Federally qualified health centers (FQHC), rural health centers (RHC), home health providers, hospice, independent diagnostic testing facilities (IDTF), renal centers, ambulatory surgical centers, and critical access hospitals (CAH) are the only exceptions to this policy. These provider types will have their enrollment date correspond with their Medicare approval letter.
Registration
