| DADS Thanksgiving Processing Schedules
Information posted November 14, 2008: DADS has provided a calendar for the DADS Holiday Claims Processing Downtime Schedules. Click on the title to view the calendar.
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| Provider Workflow Webinar / Q & A Conference Calls – Registration Now Open
Information posted November 7, 2008: TMHP will implement Long Term Care (LTC) Online Portal enhancements for a new Provider Workflow effective November 14, 2008. Provider Workflow webinars and educational materials are available separately for Nursing Facility providers and Community Waivers providers. The question-and-answer (Q&A) webinar / conference calls are available to providers to address any questions regarding the Provider Workflow. Providers are expected to have read the educational materials prior to attending a webinar Q&A session. The sessions are not a training delivery but rather an opportunity for providers to ask questions based on reading the educational materials. Click on the title for links to registration, training materials, and Information Letters. |
| TMHP Scheduled System Maintenance
Information posted October 31, 2008: TMHP will perform scheduled system maintenance to the claims engine and long term care (LTC) systems on November 9, 2008, from 6:00 p.m. until 11:59 p.m. Some functions will be unavailable during this time period. Click on the title to view the details. |
| Long Term Care Information Letter No. 2008-160:
Information posted October 31, 2008: Addressed to Community Based Alternatives (CBA), Home and Community Support Services Agencies (HCSSAs), Consolidated Waiver Programs (CWP), Program of All-Inclusive Care for the Elderly (PACE), State of Texas Access Reform Plus (STAR+PLUS), and Integrated Care Management (ICM) providers concerning new provider workflow process for community waiver providers. |
| Long Term Care Information Letter No. 2008-161
Information posted October 29, 2008: Addressed to Specialized Services and Rehabilitative Services in the Medicaid Nursing Facility. Click on the title to view the letter |
| Long Term Care Information Letter No. 2008-159
Information posted October 27, 2008: Addressed to nursing facility and hospice providers concerning the new provider workflow process. Click on the title to view the letter. |
| November Long Term Care Bulletin No. 36
Information posted October 27, 2008: The November 2008 Long Term Care Bulletin No. 36 is now available. Click the title to view the bulletin.
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| Claims Engine and Long Term Care Scheduled System Maintenance
Information posted October 27, 2008: TMHP will perform scheduled maintenance to the Claims Engine and Long Term Care systems on November 2, 2008, from 12:00 a.m. until 2:00 a.m. This is the annual Daylight Savings Time window. Some functions will be unavailable during this time period. |
| Attention Nursing Facilities: Retro Claims RUG Overlap
Information posted October 13, 2008: During the period September 1, 2008, through September 15, 2008, for clients that transitioned from a TILE to a RUG, it is possible that the claim could have retro’d if providers were first paid at a TILE level and then submitted an MDS and obtained a RUG value. As a result, the RUG overlapped a portion of the TILE segment.
In this event, the claim would have paid at the TILE level. The claim for the RUG segment that overlapped with the TILE would have denied with the EOB F0277, National Code is missing, invalid, not billable with procedure code qualifier.
Providers should check their R&S and identify denied claims with EOB F0277 and rebill, if necessary.
The system has been corrected to not deny or retro any claims.
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| Long Term Care Information Letter No. 2008-151
Information posted October 9, 2008: Information letter for Nursing Facility Providers regarding Texas Index for Level of Effort (TILE) to Resource Utilization Groups (RUGs) Hold Harmless Feature. Click on the title to link to the Information Letter. |
| New Links Announced for RUG & TILE Training through TSU
Information posted October 8, 2008: Click on the title for new links to online Texas State University RUG and Tile training. |
| Important: 3652-A Care Form Purpose Code P’s Not Grandfathered - New PASARR Screening Required
Information posted October 3, 2008: Click on the title for important details regarding Preadmission Screening and Resident Review (PASARR). |
| Nursing Facility RUG Transition, Gap in Coverage and Status Definitions
Information posted October 3, 2008: Click on the title for important details regarding Nursing Facility RUG Transition, Gap in Coverage and Status Definitions. |
| Long Term Care Information Letter No. 2008-131
Information posted October 3, 2008: Information letter for
Community Based Alternatives (CBA) Home and Community Support Services Agencies (HCSSAs), Integrated Care Management (ICM) Providers, Consolidated Waiver Program (CWP) Providers, Deaf-Blind with Multiple Disabilities (DB-MD) Providers, Primary Home Care Providers, Service Responsibility Options Providers regarding follow-up to Information Letter No. 07-125, Office of Inspector General -- Review of Personal Assistance (Attendant Care) Services. Click on the title to link to the Information Letter. |
| Long Term Care Information Letter No. 2008-146
Information posted October 3, 2008: Information letter for Community Based Alternatives Home and Community Support Services Agencies (HCSSA) and Primary Home Care Provider Agencies regarding repeal of the DADS Rule at 40 TAC §49.43 Expedited Payments System. Click on the title to link to the Information Letter. |