State Member John Slade
State Member-
John Slade started the discussion ABA Reimbursement Request for Information (RFI): Tiered Reimbursement Methodolog in the forum Open Forum 2 days ago
ABA Reimbursement Request for Information (RFI): Tiered Reimbursement Methodolog
The State of Utah is currently conducting a policy landscape assessment to understand how various state Medicaid programs structure provider payments to reflect patient complexity. Specifically, we are gathering data on whether and how states utilize <b data-path-to-node=”7″ data-index-in-node=”264″>tiered reimbursement models that adjust…
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John Slade replied to the discussion NASPO in the forum State Only Forum 2 years ago
Utah just used NASPO to procure a case management system.
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John Slade posted an update 3 years ago
3 years ago (edited)
Does anyone have a similar situation: We are having a market place insurance agent put Medicaid people on a high level marketplace plan and coach the member to indicate they already are on Medicaid so they end up with both. The provider bills a higher amount to the Medicaid managed care under the market place plan
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John Slade replied to the discussion Balance Billing in the forum State Only Forum 3 years ago
We call the provider explain the Utah Medicaid rules and follow up with a letter the requires them to pay pack the member, If we have repeated complaints of a provider we can refer them for disenrollment from Medicaid.
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John Slade replied to the discussion New York Times article: beneficiary billing in the forum State Only Forum 3 years ago
Reply to New York Times article: beneficiary billing
We have the following provider in Utah
Providence Health System, the dba is Providence Tarzana Med Cntr contract number 510216589001 NPI 1821250762 Providence Health System, the dba is Providence Tarzana Med Cntr contract number 510216589001 NPI 1821250762
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John Slade replied to the discussion Posting Final Audits in the forum State Only Forum 3 years ago
I could not get the link to work. I am sure it is user error on my part
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John Slade replied to the discussion Hospital Audits in the forum State Only Forum 3 years ago
We audit
1 day stays
Detox stays
Random Sample of all stays
RDS
Rehab
Match hospital claim to surgeon bill to ensure correct coding
