FREQUENTLY ASKED QUESTIONS
MEDICAL SUPPLIES |
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Q:
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Is a prior authorization required for medical supplies?
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A:
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As of 1/1/2009, medical supplies no longer require prior authorization with the
exception of diapers and underpads. Providers should follow the same process and
procedures set forth prior to 1/1/2009 when requesting prior authorization for diapers
and underpads.
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Q:
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Which medical supply codes do not require prior authorization?
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A: |
The fee schedules on Medicaid’s website list all the supply codes whether they require
a prior authorization or not. The web address is www.medicaid.ms.gov.
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Q: |
Do providers have to submit a Certificate of Medical Necessity (CMN) and Plan of
Care Form (POC)? |
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A: |
Providers do not have to submit these forms any longer. However, there is a new
combined CMN/POC form in Section 10.90 in the DME Provider Manual that has to be
completed and kept in the beneficiary’s medical record for auditing purposes.
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Q: |
How often does the CMN/POC form have to be updated? |
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A: |
Providers must update this form every 12 months.
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Q: |
How often does a prescription have to be updated?
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A: |
The prescription has to be updated every 12 months.
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Q: |
If providers have prescriptions dated prior to 1/1/2009, will a new prescription
be required on 1/1/2009? |
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A: |
No. The prescription received prior to 1/1/2009 does not have to be updated until
12 months after the original prescription date.
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Q: |
How do providers handle TAN’s received prior to 1/1/2009 and extend beyond that
date? |
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A: |
Providers should bill those claims without a TAN if the date-of-service is 1/1/2009
or after.
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Q: |
How do providers bill claims when the supply codes are manually priced? |
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A: |
All manually priced medical supplies require the MSRP or an invoice to be submitted
along with the claims. If you submit your claims electronically, you will need to
mail or fax the MSRP or invoice to ACS before your claims can be processed. If you
submit your claims via the web portal, you can upload the MSRP or invoice to attach
to your claims. If you submit your claims on hardcopy, you will need to attach the
MSRP or invoice to your claims and mail or fax them to ACS for processing. ACS’s
fax number is 601-206-3119.
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Q: |
How do providers bill dates that span months? |
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A: |
If a provider’s date-of-service is 1/15/2009 through 2/15/2009, two separate claims
will have to be submitted. The first claim should include the dates of service 1/15/2009
through 1/31/2009 and the second claim should include dates of service 2/1/2009
through 2/15/2009. |