Wiki Medicaid Help!!!!!!

[ivonneatanacio]

Hello Forum,
I need help, our office is located in NJ, and we are a participating provider with Medicaid, however when we send out a claim we get a denial, we have been told that a different referring provider needs to be on all codes.

Please give input.

 

[RebeccaWoodward*]

Are you a specialist? Are these HMO patients?

 

[ivonneatanacio]

Yes, We are a Specialist office and most of them are strictly medicaid.

 

[TiffanyParks]

I bill for specialist in OH and we need a referring physician (with NPI) on every claim for a consultation. You also need the referring physicians Medicaid number. Thats how we bill in OH.

 

[RebeccaWoodward*]

I agree with Tiffany. You may want to to check this information. We have specialist within our group and the lack of this information on a claim will result in a denial for HMO patients.