TheProvider Alertsare important updates from Optum and the Department. Optum generates both 999 and 277 files. BHA Vaccine Hesitancy Webinar. Email: krbeall@som.umaryland.edu. Incedo Provider Portal is easy to use, secure and available 24/7. Effective January 1, 2020, Optum Maryland will replace Beacon as the Administrative Service Organization (ASO) for Maryland's Public Behavioral Health System. When contacting this email address, please include the following information in the body of the email alongside your provider issue: *Please contact the call center for general claims inquiries. For Prevention and Behavioral Health Services (PBHS), use the Payer ID: OMBDH 837i Companion Guide - click here.837p Companion Guide - click here. O4 Global Search. MDH/BHA and Optum Maryland offer education and community events. If you are a person or a family member seeing a MDH/BHA provider, you can access relevant information with the touch of a finger: Services:Find out more about the many recovery-oriented services that MDH/BHA funds through local mental health centers! It is the responsibility of the facility to update MDH when a rate change occurs so that claims are paid at the correct amount. Optum Maryland ASO Overview Training Slide Deck (pdf) Reference the charts below to identify the acceptable proof of loss for claim submission based on the service type specifics. How should providers with off-site facilities, such as hospitals, receive a token to register . You have the right to get help and information in your language at no cost. This article provides general claim filing information for online and paper claim submissions, proof of loss, and timely filing guidelines, and related links to additional resources and troubleshooting for claims and provider systems. "Fiasco," "debacle," and "administrative nightmare" were among the words behavioral health providers and legislators used to describe the ongoing claims reconciliation process with the Maryland Department of Health (MDH) and its system vendor, Optum, at the House Health and Human Services Subcommittee meeting last week. Authorizations are required for services not covered or exhausted by Medicare for those services that typically require an authorization (COMAR 10.09.36.06 B (2) a b). Q.4 For corrected claims submission for DOS prior to date 12/29/19 submitted to Beacon, do Example inquiry reason for contacting this email address: *We recommend providers to only send inquires to the appropriate designated email address to ensure that Optum Maryland efficiently serves you. For full details, please see this provider alert. maryland.optum.com October 2020 BH2555_122019 Maryland Public Behavioral Health System (PBHS) Level of Care Appendix Click on the links below for specific information on available Levels of Care: . Uninsured Eligibility: Provider Training Guide. Providers received this payment via physical check that was distributed . 201 W. 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RCS RRP, OPTUM BH Monthly Partner Letter March 2022, OPTUM March 2022 Monthly Updates from BHA, OPTUM PROVIDER ALERT 2022 Provider Quality Self-Assessment Tools, OPTUM PROVIDER ALERT Backdating Exception Authorization Request, OPTUM PROVIDER ALERT Negative Balance Recoupment, OPTUM State Negative Balances due to Retro-Eligibility Re-Processing 1.7.22, OPTUM Bed Hold Authorization Plans 1.5.22, OPTUM BHA and MDH Tobacco Control Survey 11.24.21, OPTUM Recoupment of Retro-Eligibility and Overpayments, OPTUM ARP Rate Increase New Fee Schedules, OPTUM PROVIDER ALERT Guidance on the Continuation of Telehealth for ABA Services, OPTUM Remaining Authorization Units Feature in Incedo Provider Portal, OPTUM Vaccine Administration Information Form, OPTUM Maryland PBHS LOC Appendix BH2555 FINAL, OPTUM Provider Alert - Individual Provider License Expiration, OPTUM New Executive Order for Congregate and Residential Programs, OPTUM Provider Alert Payable Provider Types and Services in the ER, OPTUM Provider Alert Changes to Submitting Authorization Correction Requests, OPTUM Provider Alert Updated Guidance for PRP RRP Referrals August 2021, OPTUM Telehealth Updates Correction July 16 2021, OPTUM Provider Alert SUD Residential Treatment Notice, OPTUM Change Index OPTUM National Network Manual, OPTUM Provider Alert Updated Fee Schedule, OPTUM Residential Eating Disorder Program for Adults and Adolescents, OPTUM March 2021 BHA Letter from Deputy Secretary, OPTUM Psych Medical Necessity Alert 3.1.2021, OPTUM Uninsured Eligibility Alert 2.26.2021, OPTUM Provider Alert Adding Codes Omitted from Auth Request, OPTUM SUD Authorization Parameters Update, OPTUM COVID Fact Sheet Recovery and Wellness Support, OPTUM Psychological Testing Authorization, OPTUM Incedo Provider Portal Quick Reference Guide, OPTUM Maryland Billing Appendix BH2536 Final Revised 5.8.20, OPTUM Reconciliation Provider Alert Memo 7.21.2020, OPTUM Reconciliation Summary Reprort 7.21.2020, OPTUM Reconciliation Survey Provider Alert 7.23.2020, OPTUM AuthorizationAlert Update - 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November 2019, Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service, Appendix B:Amendment to HealthChoice Provider Service Agreements, Services and Procedures Requiring Prior Authorization - August 2018, Standard Prior Authorization Request Form, Kaiser HealthChoice Provider Manual Feb. 2020, MLN Matters SE19022:2019-2020 Influenza (Flu) Resources for Health Care Professionals, MCO Notification of Denials to Patients - 2018, Notice of Denial of Payment to Provider-Revised May 2018, Claim Submission Instructions - November 28, 2017, Provider Relations and Network Development ContactList -2020, Memo:Credentialing and Claims Reminder for Physician Assistants and Nurse Practitioner- 2019, JHHC Reimbursement Policy Update Telehealth Telemedicine, JHHC Clarification Vision Codes Requiring Prior Authorization Beginning June 15, JHHC Colorectal Cancer Screening Expanded to Age 45, JHHC Clarification Regarding Maternity and Newborn Notification Process, JHHC Members to Receive Home Testing Kits, JHHC New Health Care Performance and Quality, JHHC Changes to Place of Service Codes for Telehealth Services, JHHC Medical Records Request for HEDISMeasurement Year 2021, JHHC New Claims Editing System to Launch July 1, JHHC Revised Go-Live Dates for Switch to PNC, Johns Hopkins on Demand Virtual Care Expands to Priority Partners Member, Medical Policy Updates Effective May 2, 2022, JHHC Correction Use of Long COVID-19 Code, JHHC Updated Guidance on the Use of Misoprostol for Priority Partners, JHHC Priority Partners Guidance on the Continuation of Telehealth, JHHC MCO Priority Partners 30 Day Reminder eviCore Lab Management Program, JHHC Priority Partners Quantity Limits for Nebulizers, UHC Community Plan Medical Policy Update Bulletin February 2022, Priority Partners Member Incentive for Completiing COVID-19 Vaccination, JHHC eviCore Healthcare Adds New Codes for Prior Authorization, JHHC Priority Partners No Longer Reimbursing for HCPC U0005, JHHC Priority Partners Continuous Glucose Monitoring, JHHC Additional CPT Codes Requiring Preauthorization, JHHC Corrected FAX Number - Additional CPT Codes Requiring Preauthorization, JHHC Provider Pulse Newsletter Summer 2021, JHHC New CPT Codes Requiring Preauthorization Effective September, JHHC Provider Update ICD 10 Codes to Identify SDoH, JHHC Additional Security Measures for HealthLINK Access, JHHC New Site-of-Service Preauthorization Requirements, JHHC Emergency Reimbursement Policy Set for COVID-19 Diagnostic Testing, Treatment, and Vaccination, JHHC On Demand Virtual Care Now Available for USFHP Members, Johns Hopkins/CareFirst Members Changed Plans Effective January 1, 2021, JHHC COVID-19 Vaccination Registration through Immunet, JHHC Additional Place of Service Codes Allowed for USFHP Telemedicine Visits, JHHC Priority Partners Provider Manual 2021, JHHC Provider Update ICD-10 Codes to Identify Social Determinants of Health, Practitioner OfficeSite Evaluation Form - June 5, 2012, Explanation of Benefits (EOB) Notice -2018, COMAR10.09.71.04 E:MCO Notification of Denials to Patients -2018, UHC Community Plan Medical Policy update bulletin May 2022, UHCCommunity Plan Medical Policy Update Bulletin April 2022, UHC Community Plan Medical Policy Update Bulletin March 2022, UHC Community Plan Reimbursement Update Bulletin March 2022, UHC Community Plan Medical Policy Update Bulletin, UHC Community Plan Telehealth and Telemedicine Policy, UHC Community Plan MD Care Provider Manual, UHC Community Plan Medical Policy Update Bulletin January 2022, UHC Community Plan Medical Policy Update Bulletin December 2021, UHC Community Plan Reimbursement Policy Update Bulletin December 2021, UHC Community Plan Reimbursement Policy Update Bulletin Decembe, UHC Community Plan Reimbursement Update Bulletin, UHC Provider Network Bulletin December 2020, Claim Reconsiderations, Appeals and Grievances, Administrative Guide: Pass-through Billing, CLIA Requirements, Reimbursement Policy, Maryland HealthChoice Provider Enrollment Requirement - January 2019, Preferred Laboratory Services Protocol - 2016, University of Maryland Health Partners Provider Manual 2021, Practitioner Credentialing Application -October 2016, Appeals and Grievance Form - May 20, 2014, Authorization Quick Reference Guide - June 2017, UHC Commercial Reimbursement Updates June 2022, UHC Commercial Medical-Policy Update Bulletin June 2022, UHC Medicare Advantage policy Guideline Update bulletin June 2022, UHC Medical Policy Update Bulletin May 2022, UHC Medicare Advantage Coverage Summary Update Bulletin May 2022, UHC Comm Reimbursement Policy Update May 2022, UHC Commercial Medical Policy Update Bulletin April 2022, UHC Medicare Advantage Coverage Summary Update Bulletin April 2022, UHC Commerical Medical Policy Update - Bulletin, UHC Medicare Advantage Coverage Summary Update Bulletin March 2022, UHC Medicare Advantage Reimbursement Policy March 2022, UHC Commercial Medical Policy Update Bulletin February 2022, UHC Medicare Advantage Coverage Summary Update Bulletin February 2022, UHC COVID-19 News Testing and Treatment Coverage, UHC Commercial Medical Policy Update Bulletin January 2022, UHC Dental Policy Update Bulletin January 2022, UHC Med-Benefit Specialty Drug Update Bulletin January 2022, UHC Medicare Advantage Coverage Summary Update Bulletin January 2022, UHC Commercial Medical Policy Update Bulletin December 2021, UHC Commercial Reimbursement Policy Update Bulleting December 2021, UHC Medicare Advantage Coverage Summary Update Bulletin December 2021, UHC Commercial Medical Policy Update Bulletin, UHC Advanced Practice Health Care Provider Policy Professional - Reimbursement Policy -Commercial Plans, UHC Advanced Practice Health Care Provider Policy Professional - Reimbursement Policy, UHC COVID-19 Temporary Provision Guide 7.20.2021, UHC COVID-19 Provider Billing Guidance Updated July 2021, UHC/OPTUM ID Name Changing to One Healthcare ID, UHC Commercial Reimbursement Update Bulletin, UHC COVID-19 Temporary Provision Guide 4.19.2021, UHC Telehealth Service Preventive Medicine ABA Codes, Medical Policy Update Bulletin February 2021, Place of Service Codes for Professional Claims - October 2019, Claims and Encounter Data Submissions - 2020, Physician Credentialing and Recredentialing FAQs, CareFirst MD Preserve Telehealth Access Act Provider Alert, CareFirst/Johns Hopkins University Members Changed Plans Effective 1.1.2021, CareFirst on Call: Professional Reference Card- August 2018, Member Identification Card Quick Reference Guide, Precertification Request for Authorization of Services, Professional Provider Relations Representatives, Provider Portal User Guide: Remittance/Notice of Payment, Quick Reference Guide for Health Care Professionals - May 2020, Dental and Oral Surgery Claim Documentation Guidelines - April2019, Women's Health Programs and Policies - April 2019, Delegation Provider Guide - February 2020, Provider and Facility Participation Criteria - 2019, Better Health of Maryland:Provider Guide - March 5, 2019, JHHC Reimbursement Policy update Telehealth Telemedicine, JHHC Gender Affirming Procedures and Treatment Medical Policy, JHHC Reminder New Claims Editing System to Launch July 1, JHHC eviCore Laboratory Management Program for Johns Hopkins Advantage MD, JHHC New CPT Codes Requiring Prior Authorization Effective July 15, 2022, JHHC Medical Records Request for HEDIS Measurement Year 2021, JHHC New CPT Codes Requiring Prior Authorization, JHHC Federal Transparency in Coverage Rules Now in Effect for Johns Hopkins EHP, JHHC Reminder - Please Use Correct Address, JHHC COVID-19 Reimbursement Policy Update, JHHC Medical Policy Updates Effective February 2022, JHHC New Prior Authorization Requirements, JHHC Reminder of Utilization Management Processes in Light of Recent COVID Surge, JHHC Temporary Revisions of Utilization Management, JHHC Updated Reimbursement Guidance for CPT 99072, JHHC - 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