Pa Promise Billing Guide. Providers may bill for the outreach bonus (code 99429 with the HD

Providers may bill for the outreach bonus (code 99429 with the HD modifier) for each recipient recruited into the Healthy Beginnings Plus Program during the first trimester and receiving … Pennsylvania’s Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program Periodicity Schedule and Coding Matrix (Periodicity Schedule) and the Age Range … In order to avoid possible delays in processing, providers must bill claims with all appropriate identifiers validating that both the billing and rendering providers and their service locations are … Companion guides are developed to communicate the Pennsylvania Medicaid-specific information required to successfully submit healthcare … This Companion Guide was developed to communicate the Pennsylvania Medical Assistance-specific information to process transactions in the NCPDP Version D. February 20, 2007 – Effective February 20, 2007, the Department issued Medical Assistance Bulletin (MAB) 26-07-01 (Clarification of Procedure Codes and Modifiers to be used when … PROMISe (TM) Provider Internet User Manual Click on PROMISe (TM) Provider Internet User Manual to open the resource. Providers may bill for the outreach bonus (code 99429 with the HD modifier) for each recipient recruited into the Healthy Beginnings Plus Program during the first trimester and receiving … This data, furnished in connection with this document, shall not be disclosed outside DXC Technology and shall not be duplicated, used, or disclosed in whole or in part. 0 04/05/2012 Entire Document Update from 5010 Provider Trainers / Documentation Team Version 2. 0 format. 1 06/12/2012 Section 4. Below are links to documents that contain helpful tips for Medicaid providers and their staff. The requirement to bill within 180 days from the DOS still … Pennsylvania Specific Medical Assistance HIPAA Billing Guide Preview 3 hours ago Pennsylvania PROMISe™– 837 Health Care Claim: Professionals Companion Guide August 2016 Page 1 … Pennsylvania PROMISe™ Companion Guide You must follow these instructions to complete the CMS-1500 claim when billing the Department of Human Services. 6 12/14/2012 TOC Removed names Documentation Team Version 2. If PA Health & … PROMISe™ Internet Portal© 2025 Hewlett-Packard Development Company, L. When providing services to a child and family by Tele-Intervention, the provider must identify the Place of Service for Tele-Intervention on the billing claim in Promise. Attention Community HealthChoices Providers: All billing, rendering and service location provider information will be subject to up front editing against the PROMISe™ system. CMS-1500 Billing Guide for PROMISe™ Healthy Beginnings Plus CMS-1500 Billing Guide for PROMISe™ Healthy Beginnings Plus The timely-filing requirement applies to PROMISeTM and awaiting an authorization in HCSIS does not equate to an inability to bill. All rights reserved. | Privacy Notice Reference number: [0000350] Revision Date: [09/10/2025] Version 1. Code § 1101. The billing guides found below are in Adobe PDF format. 0/Pharmacy Billing Handbook to obtain general information, eligibility verification instructions, Remittance Advice … The following PA PROMISeTM providers should access the NCPDP D. | Privacy Notice This Companion Guide was developed to communicate the Pennsylvania Benefit Enrollment and Maintenance-specific information required to successfully interpret the 834 transaction. CMS1500 Billing Guide for Promise Renal Dialysis Centers Purpose of the document The purpose of this document is to provide a blockbyblock … This packet contains information which will help guide you through the PROMISeTM Provider Enrollment Process. The need for these services must be identified in the Healthy Beginnings Plus Care … UB-04 Billing Guide for PROMISe™ Inpatient Hospitals Purpose of the Document The purpose of this document is to provide a block-by-block reference guide to assist the … Providers may access the PROMISe™ website for claim status, online claim submission, Provider Enrollment, Eligibility Verifications, requesting … This data, furnished in connection with this document, shall not be disclosed outside DXC Technology and shall not be duplicated, used, or disclosed in whole or in part. These providers should refer to the MA Program Fee … This data, furnished in connection with this document, shall not be disclosed outside DXC Technology and shall not be duplicated, used, or disclosed in whole or in part. … The purpose of this document is to provide a block-by-block reference guide to assist the following provider types in successfully completing the CMS-1500 claim form: Department of Human Services Please refer to your specific provider type billing guides in the appropriate Provider Handbook. PA PROMISe Provider Internet User Manual PA PROMISeTM Provider Internet User Manual The Department of Human Services (DHS) offers state of the art technology through PROMISe™ — its claims processing, provider enrollment, and … Outpatient Hospital clinics / Independent Medical Surgical Clinics who are billing EPSDT complete screens will bill on the CMS-1500/837P. This includes bills representing a … The Medical Assistance Bulletin 08-24-04, issued by the Department of Human Services (DHS) Office of Medical Assistance Programs (OMAP), provides updates to the … The Medical Assistance Bulletin 08-24-04, issued by the Department of Human Services (DHS) Office of Medical Assistance Programs (OMAP), provides updates to the … You must follow these instructions to complete the CMS-1500 claim form when billing the Department of Human Services. Pennsylvania PROMISe Companion Guide for 835 Remittance Advice transactions. HIPAA compliant instructions for healthcare providers. Agencies can bill services to Pennsylvania Promise Medicaid OLTL … CMS-1500 Billing Guide for PROMISe™ Healthy Beginnings Plus Friday 12/26/2025 03:14 PM EST PROMISe™ Internet Portal October 2025, Version 2. Do not imprint, type, or write any information on the upper … 1. Billing and Claims Quick Reference Guide The Aetna Better Health® Kids Billing and Claims Quick Reference Guide serves as a useful resource to providers and staff to aid in … CMS-1500 Billing Guide for PROMISeTM Personal Care Services Providers Purpose of the document The purpose of this document is to provide a block-by-block reference guide to … 438. 22 Address any comments concerning the contents of this manual to: Gainwell Technologies Attention: Documentation Unit See 42 CFR 405. 35 Address any comments concerning the contents of this manual to: Gainwell Technologies Attention: Documentation Unit This guide is an on-the-job reference to screens associated with billable claims within PELICAN EI. 2402; and Meets all applicable requirements for MA providers as set forth in 55 Pa. This includes bills representing a … This Companion Guide was developed to communicate the Pennsylvania Medical Assistance-specific information required to successfully submit the 276/277 transaction. Provider Internet User Manual PROMISe™Internet Portal PA PROMISe™System Documentation PROMISeProviderInternetUserManual. of updates to the PROMISeTM Provider Handbook – “837 Dental / ADA – Version 2024 Claim Form” and PROMISeTM Provider Billing Guide – “ADA Claim Form – Version 2024 … Version 2. 7 01/16/2013 Section 4 Updated EVS search criteria Documentation Team Version … CMS-1500 Billing Guide for PROMISe™ Therapists Purpose of the Document The purpose of this document is to provide a block-by-block reference guide to assist the following provider types … Home PROMISe™ Internet Portal PROMISe™ Internet Portal© 2025 Hewlett-Packard Development Company, L. CMS-1500 Billing Guide for PROMISeTM Ambulance Providers Purpose of the document PROMISe Place of Service Crosswalk Below is a table that shows how Place of Service codes have been crosswalked for PROMISe™ billing … CMS1500 Billing Guide for Promise Ray Clinics Purpose of the document The purpose of this document is to provide a blockbyblock reference guide to assist the Department of Human Services This Companion Guide was developed to communicate the Pennsylvania Medical Assistance-specific information required to successfully interpret the 835 transaction. If you notice inconsistencies or inaccuracies within the Medical Assistance Outpatient Online Fee Schedule tool such as incorrect modifiers with procedure codes, incorrect pricing segments, … J1l This packet contains information that will help guide ODP providers through the PROMISeTM Provider Enrollment Process. Use the following links to go directly to the document you would like to … ODP PROMISeTM Provider Enrollment Readiness Packet This packet contains information that will help guide MR providers through the PROMISeTM Provider Enrollment Process. Do not imprint, type, or write any information on the upper right hand … 1. CMS-1500 Billing Guide for PROMISeTM Rural Health Clinics (RHCs) & Federally Qualified Health Centers (FQHCs) Purpose of the document The purpose of this document is to provide … This data, furnished in connection with this document, shall not be disclosed outside DXC Technology and shall not be duplicated, used, or disclosed in whole or in part. CMS-1500 Billing Guide for PROMISeTM Non-Traditional Provider The purpose of this document is to provide a block-by-block reference guide to assist the following provider types … Providers should log into PROMISe to check the revalidation dates of each service location and submit revalidation applications at least 60 days prior to the revalidation dates. 0/Pharmacy Billing Handbook to obtain general information, eligibility verification instructions, Remittance Advice … In order for a provider to submit a claim successfully and be approved for payment, it is important that the provider understands the ODP billing process and rules surrounding it. docx April 25, 2019 Library Reference Number: … Provider Internet User Manual PROMISe™Internet Portal PA PROMISe™System Documentation PROMISeProviderInternetUserManual. This reference guide is targeted to the following user roles: To comply with MA regulations at 55 Pa. 17 PROMISeTM/LIHEAP Vendor Internet User Manual This Companion Guide was developed to communicate the Pennsylvania Medical Assistance-specific information to process transactions in the NCPDP Version D. This restriction … In order for providers to participate with the Department of Human Services (DHS), they must first enroll. Code Chapter 1101, relating to General Provisions, and 55 Pa. … Detailed billing instructions are included in the PROMISeTM Billing and Companion Guides which are available on the Office of Medical Assistance Programs (OMAP) website at … UB-04 Billing Guide for PROMISeTM Ambulatory Surgical Centers Aetna Better Health of Pennsylvania follows Department of Human Services (DHS) guidelines for claims processing. This restriction … PURPOSE The purpose of this billing guide to provide guidance on Medical Assistance (MA) Fee For Service (FFS) Billing for our OCDEL funded Nurse-Family Partnership (NFP) providers. 8 Updated Copayment Desk Reference link … Managers The purpose of this document is to provide a block-by-block reference guide to assist the following provider types in successfully completing the CMS-1500 … CMS-1500 02/12 Reference Guide for PROMISe™ CMS-1500 02/12 Reference Guide for PROMISeTM Effective July 1, 2014, professional claims submitted via paper billing … 1 – Admit Through Discharge Claim This code is used for a bill that is expected to be the only bill received for a course of treatment or inpatient confinement. CMS-1500 Billing Guide for PROMISe™ Home Residential Rehabilitation Providers Purpose of the document The purpose of this document is to provide a block-by-block reference guide to … This Companion Guide was developed to communicate the Pennsylvania Medical Assistance-specific information required to successfully submit the 837 Professional transaction. This restriction … Provider Billing and Payment In order for Office of Developmental Programs (ODP) direct service providers to receive payment for Waiver-Funded services rendered, they are required to … PA PROMISeTM Provider Internet User Manual SYSTEM DOCUMENTATION LIBRARY REFERENCE NUMBER: [00000164] SECTION: 4-5B LIBRARY REFERENCE NUMBER: … Medicaid Regulations, Handbooks, Guides, & Manuals If you are having difficulty finding the document or information you need, please … Professional Medicare HMO Billing Instructions CMS-1500 Commercial Insurance Attachment (MA 538) CMS-1500 Medicare Attachment (MA … November 2023 Version 2. A PA PROMISeTM Banner Page will be included as part of the first page (or as an insert in the RA Statement) when DHS has a need to disseminate information quickly to the provider … CMS-1500 Billing Guide for PROMISeTM Hospice Providers Purpose of the document. The Provider … This Companion Guide was developed to communicate the Pennsylvania Benefit Enrollment and Maintenance-specific information required to successfully interpret the 834 transaction. This restriction … CMS 1500 ODP PA Promise is a new billing type based off existing billing functionality, with additional features added. P. docx April 25, 2019 Library Reference Number: … 1 – Admit Through Discharge Claim This code is used for a bill that is expected to be the only bill received for a course of treatment or inpatient confinement. Providers who are DHS billing agents – formerly known as “business partners” – must follow the instructions in this section to log on to the PA PROMISeTM Internet site. 52 Billing for Partial Months The LTC facility will begin billing on the date of admission or date the CAO decides that the individual qualifies for payment of LTC services. The providers and recipients used for these examples are fictitious. In order to avoid possible delays in processing, providers must bill claims with all appropriate identifiers validating that both the billing and rendering providers and their service locations are … Documentation Team Version 2. Please choose the appropriate provider type or specialty below to view the PROMISe™ handbook and billing guide appropriate for you. Code Chapter 1129, … LARC Effective with dates of service on and after December 1, 2016, the DHS will pay inpatient hospitals (Provider Type 01 and Specialty 010) for LARC (Long Acting Reversible … Provider Handbook UB-04 January 30, 2017 UB-04 Billing Guide for PROMISe™ Inpatient Hospitals Purpose of the Document The purpose of this document is to provide a block-by … Providers billing for Counseling Services must meet the qualifications outlined in the HBP manual. The following PA PROMISeTM providers should access the NCPDP D. Billing guides for paper claim form completion can be located on the DHS website at: Promise Handbooks (pa. 68(a), relating to invoicing for services, providers must bill for MA services according to instructions contained in the provider handbooks. gov) This Companion Guide was developed to communicate the Pennsylvania Medical Assistance-specific information required to successfully submit the 837 Institutional Outpatient transaction. 1. bk1tsoarv
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