ForwardHealth Medicaid Information & Resources

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ForwardHealth MedicaidInformation ResourcesKatherine FischerNov 6 2015o Medicaid Enrollment Wizard and Resources.
o Review Submitted questionso Portal Overview and Resources General Portal navigation Provider related links Resources and communications .
For Dentist You have been approved Nowo Dental Providers facilities can request a Waiver to be both abiller AND a renderer o Review Sample Lettero Compose and mail request to .
Alan WhiteDepartment of Health ServicesOffice of the Inspector General1 W Wilson StP O Box 309.
Madison WI 53701 Frequently Asked Questionso What is the difference between Straight Medicaid andMedicaid HMO o Answer Straight Medicaid means the members are part of fee.
for service you would bill Medicaid WI ForwardHealth directlyvia the Portal If the members belong to an HMO then in orderto be able to be reimbursed for services for them you wouldneed to contract directly with the HMO FAQ Continued .
o EHR vs Paper We understand that billing to Medicaid mustbe done electronically however does the FCC free charitable clinic have to have electronic health records EHRs or can they still do paper charting Are audits done to reviewbilling what is looked at and needs to be kept .
o Answer You can submit claims electronically or by paper however there is a 1 10 charge for paper submissionTopic 10637o Topic 201 202 and 204 FAQ Continued .
o HIPAA What are the HIPAA requirements that are applicableto a FCC that accepts Medicaid Do you have sample formsthat an FCC Medicaid patient would need to sign o Answer Topic 200 FAQ s Continued.
o Reimbursement What are the reimbursements for dental andbehavioral health How do the copays work Answer Max fee Scheduleo Do we need certified coders Can the coders and billers bevolunteers of the clinic or must they be paid employees .
Answer This is an Administrative question and we can not giveyou specific guidance on this matter FAQ s Continuedo Are Free Clinics required to ask members for the copay or arethey able to simply write them all off and take the hit.
o Answer Wisconsin statutes at s 49 45 18 ac require thecollection of copayment unless the provider determines thatcollecting such copayment would exceed the amount to becollected Further the law states that payments to providerswill be reduced by the specified copayment Please see.
language at https docs legis wisconsin gov... 49 IV 45 18 FAQ s Continuedo Could a provider that is certified Medicaid at one clinic provideservices at a different clinic .
o Answer Yes FAQ s Continuedo Medicaid Certification but not bill see Medicaid Can a FCCapply for a Medicaid Certification so that they can look up iftheir patients have BadgerCare but not actually see Medicaid.
patients nor bill Medicaid o Answer Yes Application fee may apply depending onprovider type FAQ s ContinuedoIs there differences in reimbursement on clinic vs provider .
Answer No difference in payment FAQ s Continuedo Liability requirements for being a Medicaid Certificate clinic What insurances are needed i e risk bonding liability professional clinic malpractice etc are required of a Medicaid.
provider clinic Does use of the VHCP suffice o Answer For this you will need to follow up with Regulationsand Licensing Questions Cont o Free Clinics that receive the Dental waiver allowing the clinic.
to be both biller performer do the practicing dentists haveto be Medicaid certified o Answer The Dental Waiver exempts all practicing dentistswith the approved clinic from having to be Medicaid certified o This is the only provider type that this currently applies to .
Overview and Resources Thank YouForwardHealth Medicaid Information & Resources Katherine Fischer Nov. 6, 2015 Agenda Medicaid Enrollment Wizard and Resources Review Submitted questions Portal Overview and Resources. General Portal navigation. Provider-related links. Resources and communications. For Dentist… You have been approved!

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