Claims and Related Documents
Claims
- APUPD Process
- APUPD Weekly Schedules and Status
- BENEF Explanation (Sample)
- Board Operations Manual-HIPAA Claims Section (large file)
- BRULE Explanation
- BRULE Explanation (Sample)
- Caution/Outlier/Notify Reports Documentation
- HIPAA Notify Program (large file)
- Cheat Sheets and FAQs
- Claims and Payment Training (PDF, large file) (PowerPoint, large file)
- Claims Billing, Weekly Schedules and Status
- Claims Contacts (by Name) (by County)
- Claims Post Report Layout (102 ASCII File)
- Claims Users Group Training - 5/24/05
- Codes
- Contracts, Pricing & Adjudication Training (PDF) (PowerPoint)
- Contract, PSCHD, & Procedure Code Tables
- Correcting MACSIS Medicaid Claims Priced Using Tiered Payment Logic
- Creating/Terming Contracts in Diamond
- Denying Claims Beyond Submission Deadline
- Fixing Retroactive Medicaid-Eligible Claims
- HIPAA Price Schedules (Excel) (PDF)
- HIPAA Service Rate Form (Tier 2)
- ODADAS Service Codes (PDF) (Excel)
- ODMH Service Codes (PDF) (Excel)
- HIPAA Service Rate Form (Tier 2) Instructions
- MACSIS HIPAA Claim Correction Policy
- MACSIS HIPAA Claim Correction Procedure
- MACSIS HIPAA Claim Correction Form (Word) (PDF)
- MACSIS HIPAA Claim Correction Form Instructions
MACSIS Testing Information
- MACSIS HIPAA EDI Claims Testing & Approval Policy
- Submitting Test Claim EDI Files For Approval
- MACSIS EDI Claims Testing Request Form (Word)
- MACSIS 837 Professional Claim v5010 Information Guide
MACSIS Technical Informational Guides
- Sample 837 - 5010 File
- 837 Professional Claim v5010
- 837 Professional Claim v4010 - NPI Format
- Sample 837P NPI File
- 835 Health Care Claim/Payment Advice - 5010 Format
- Sample 835 - 5010 File
- 835 Health Care Claim/Payment Advice - NPI Format
- Sample 835 NPI File
- Member/Claims Transfer Request Form (Word) (PDF)
- Member/Claims Transfer Request Form Instructions
- MH Roll-up Categories for Duplicate Checking
- ODADAS Roll-up Categories for Duplicate Checking (large file)
- Naming Conventions
- Provider (PROVF) Information Listing