A. When you split a claim, the claim header is an exact duplicate of the original claim. If the original sequence number is incorrect, you will need to manually change it on the header screen.
A. No. You may request a post immediately. Boards no longer have to perform the duplicate claim checking that was required in MHPROD. This is due to the required roll-up of claims and the way duplicate claims are handled in MHHIPAA.
A. Claims are rolled-up if the UPI, UCI, date of service, procedure code, modifier 1 and 2 are the same. Same-day MH Medicaid reimbursable services with the place of service codes of "09" or "51" should not be summed (rolled-up).
A.The State will continue to produce these files unless staffing issues arise.
A. No. If there is a contract with the client's panel and LOB it will never hit the default contract. What happened is you took the price schedules off the main PROVC record but not the PROVD records. The rate for H0004 (MH group counseling) is attached to the price schedule that is on the PROVD record.