Prior to the billing system, this program was billing for ALL of its consumers by manually entering in the claim and consumer information into the payer website.
Who is Adult Foster Care - Northeast Arc
100
The name of the electronic file used to check a consumer's eligibility.
What is the 270 File?
100
The name of the Medicaid Payer in Texas?
What is TMHP?
100
A name for the electronic claim payment file name.
What is the 835 file?
100
This developer sometimes works on the billing module and he has his own bathroom.
Who is Octavian?
200
This client has taken the longest to transition to the re-written system; in fact they still are not yet live on the re-write.
Who is Northeast Arc Fiscal Intermediary (NE Arc FI)?
200
The name of the electronic file with eligibility responses.
What is the 271 file?
200
The umbrella term for payers that are for consumers 65 or older in Massachusetts.
What are SCOs (Senior Care Options)?
200
The name of the paper form used to submit paper claims.
What is the CMS 1500?
200
This developer knows billing pretty well, because he used to be on our team!
Who is Isaac?
300
This billing client is run by a husband and wife team.
Who is In Home Attendant Services (IHAS)?
300
The name of the record of consumer information that the billing system sends to the payer.
What is Trading Partner Record?
300
The name of the Massachusetts Medicaid program.
What is Masshealth?
300
An ICD_10 diagnosis code
What is V91.07 Burn due to water-skis on fire"?
300
The name our billing developer goes by on Flowdock.
What is Greggles?
400
The error code that comes up on the eligibility response file.
What are AAA Codes?
400
This payer required us to re-write the billing system since they allowed for multiple services per claim.
What is Amerigroup?
400
The name of the standard requirements for sending claim information electronically.
What is the EDI_x12 (Electronic Data Interchange)?
400
We wouldn't be giving this presentation if it weren't for this developer, who built the module from the ground up!
Who is Eric?
500
The three types of eligibility a consumer can be labeled as in the billing system.
What are eligible, ineligible, and unknown?
500
This newest team member has a last name that is a bean, car, and horse? Who is he?