Strategies for Successful Billing of Kentucky Medicaid Waivers

Strategies for Successful Billing of Kentucky Medicaid Waivers

You’ve mastered the skill of providing quality services under the Kentucky Medicaid Waivers and you finally understand the state regulations. But without an effective and efficient method of keeping records and filing claims, all of your effort is for naut. Without the proper systems in place for maintaining records and billing data, you may be delaying your reimbursement and losing money every day.

Follow these strategies to maximize your reimbursement:

Maintain accurate records.

Develop a system for recording start and end times of all billable services. Many services may not be performed in conjunction with other services, so this should be accounted for. Understand the regulations for each service you provide to ensure you’re billing appropriately.

Use technology.

If you aren’t using technology to organize and store your billing records, you should begin doing so now. OASIS Bridge is designed specifically for data management for agencies that bill Kentucky Medicaid Waivers. Documents and reports are available anywhere you have access to a computer, tablet or smart phone with internet access. You will experience a reduction in errors and redundancy and have online access to your billing records.

Submit your claims electronically.

According to EDI, paper claims submitted on CMS 1500 forms go through several clerical channels prior to being processed. When a claim is suspended, this can increase the time between receipt of the claim and payment by weeks. Submitting your claims electronically allows for more efficient claims management and faster turnaround.

Follow up on denials now.

Claims that are denied or suspended should be addressed promptly to improve your chance of recouping those dollars. A list of codes assigned to denied claims can be found here. If you need assistance with resolving a denied Kentucky Medicaid Waiver claim, you should contact Carewise or EDS. A list of resources and phone numbers is available here.

Timely and accurate filing of your claims is essential in the success of your agency. With the use of technology, you reduce the opportunities for human error. Find a method that works for your agency and develop systems to ensure accuracy and efficiency. With the right systems in place, you can maximize your reimbursement and experience faster turnaround time on your claims, protecting you from potential financial losses.