First Coast Advantage (FCA) hosted it's 6th Provider In-service June 1-2, 2011.  

Below is the information that was provided at the in-service.  Please share this information with your staff.

 

Provider In-Service Information

 

       Provider In-Service Presentation (All Slides)-June 2011 

    

Introduction & Welcome Slides

Welcome Slide

Contact Information for Contract Manager

 

Provider Relations Slides

Provider Relations Visits

Website Demo

Transportation Information

Contact Information for Provider Relations

 

Member Disenrollment & Transfer Process Slides

Types of Disenrollment/Transfers & Form

Voluntary Disenrollments

Member "No Show" Types

Member "No Show" Form

Involuntary Disenrollment & Forms

Behavioral Verbal Warning Form

Types of Involuntary Disenrollment

Suspected Confirmed Fraud

Fraud Reporting

Behavioral Disenrollments

Involuntary Disenrollment Necessary Documentation

Additional Documentation State Can Request

Disenrollment Exceptions

Denial Fax to Provider Guidelines & Form

Contact Information for Technical Reporting Analyst

 

Utilization Management/Pre-Authorization Slides

Pre-Authorization Turnaround Time Frames

Pre-Authorization Process

Pre-Authorization List Additions

Pre-Authorization 2010 Changes

Oxygen and Supplies (CPAP & BIPAP)

Consumable DME

Pre-Authorization List Revised

Contact Information for Utilization Management/Pre-Authorization

 

Enrollment/Eligibility Slides

Enrollment Verification

Medicaid Enrollment Eligibility Example

Non-Medicaid Eligibility Enrollment Example

Contact Information for Eligibility - Claims Manager

 

Billing & Claims Slides

Direct Submission of Claims to HP

Direct Submittal Providers

NPI Registration Information

Submission of Electronic Claims to FCA

Submission of NPI on CMS 1500

Submission of NPI on UB04

Submission of Paper Claims

Timeline for 5010 Implementation

Common Errors Paper Claims CMS 1500 & UB04

Unlisted Procedures

By Report Procedures

DME Manual Price Items

Submission of Appeals

Claim Reminders

Contact Information for Billing & Claims