Department of Medical Assistance Services
Billing, MMIS Transition, Pharmacy And Utilization Review
Billing, MMIS Transition, Pharmacy And Utilization Review Image
BILLING OVERVIEW
This presentation is to facilitate training of the subject matter in the Virginia Medicaid Hospital Manual. It contains only highlights of this manual and is not meant to substitute for or take the place of the Hospital Manual.
Bullet CMS-1500 Physicians Billing Guidelines
Bullet Hospital Medicaid 101- The Basics and UB-04 Billing Guidelines
Bullet DMAS-30 (Title 18) Common Billing Errors
Bullet Direct Data Entry Institutional Billing Guidelines
Bullet Direct Data Entry Professional Billing Guidelines
Bullet Direct Data Entry Medicare Crossover Part B Billing Guidelines
UTILIZATION REVIEW OVERVIEW
The PAUR unit performs audits on all Acute Care and Psychiatric facilities on an annual basis. The attached presentation is the most common questions and answers received by the unit for the hospital audit process.
Bullet Medicaid Hospital Utilization Review and DRG Audits: FAQs?