Provider Notice issued 03/18/15

Monthly Billing Requirement

This Notice informs certain long term care facilities, Supportive Living Program providers and facilities eligible for provisional licensure under the Specialized Mental Health Rehabilitation Act of 2013, that the Department of Healthcare and Family Services (HFS) plans to release a series of notices that will provide information regarding the provision of P.A. 98-0104 (pdf) to submit monthly billing claims for reimbursement purposes.

Facilities identified as Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) and State Operated Facilities (SOF) will not be included at this time.

Facilities must transition to the HIPAA-compliant X12 837 claim format or the paper UB-04 format for monthly claim submission. The effective date for implementation is July 1, 2015. Current system processing will remain in place until the new system is operational.

Future Informational Notices will explain any necessary operational or structural changes, policies and procedural changes, instruction and training, and Administrative rule revisions.

James M. Parker, Acting Administrator

Division of Medical Programs