Administrative Memos

200006

FROM: Theodore O. Will, Chief Executive Officer
DATE: Aug 03, 2000
SUBJECT: Rebilling After a Denial
IPRO CONTACTS:

Patti G. Weinberg, Vice President, Medicaid/ State Health Care Evaluation, ext.617
Joseph Kasper, Assistant Director Information Systems, ext. 379

Please be aware that if a provider wishes to rebill Medicaid (for ALC or other services) after the receipt of an IPRO final denial, this bill must be submitted within ninety (90) days of notification by IPRO. This policy also holds for any other rebilling (changes or reversals) to previously voided claims. Medicaid will not consider claims for payment which are rebilled after the 90-day period. IPRO will not issue a revised authorization letter to rebill if the 90-day time period is exceeded.

Please see the attached administrative directive from the May 1999 DOH Medicaid Update for further clarification.

Should you have any further questions or require additional information, please feel free to call either Patti G. Weinberg, Vice President, Medicaid/ State Health Care Assessment, ext. 617 or Joseph Kasper, Assistant Director Information Systems, ext. 379.