Medicaid Managed Care Nursing Home Transition

Claims/Billing submission

Clean Claim example


What´s being denied?

  • Usage of inappropriate revenue codes as per contract
    (ex. 0100-0101 versus 0191-0194)
  • Timely filing is within 90 days from the discharge date
  • When HP/AGP is the secondary payer we require a copy of OHI´s EOP along with claim billed to Healthplus Amerigroup for applicable coinsurance payment