September 12, 2016
The post from last week with a strategy for preventing a particular type of denial is still relevant and, thanks to our friends at VACSB, we have learned today that DBHDS believes that it will have the “tier” entered to prevent denial of billing for H2022 (Group Home Residential) entered by the end of the week. The communication from DBHDS indicated that levels/tiers were being entered into both VaMMIS (which we can not see) and WaMS (which we can see); and suggested that providers delay billing until they could get all of the information entered. If, in fact, they are entering the data in WaMS, you can confirm that it is there; if it is not follow the previous directions to be sure that you can bill timely. If you claims have been denied, DMAS is forwarding the information to DBHDS with a request for immediate action. At this point, DBHDS has not addressed the status of data entry for individuals who may be in other “tiered” services which, we suspect, may also result in denied claims.