Fee-for-Service Funding. The fee-for-service payment method is based on the approved service code used with acceptable submission of all required documentation, forms, and/or reports. Grant recipients will be reimbursed using the fee-for-service reimbursement method by submitting claims to the Texas Medicaid Healthcare Partnership (TMHP) for direct clinical care services provided to Clients, which will then be paid by HHSC. The Texas Medicaid Provider & Procedure Manual (TMPPM) includes information related to HHSC FPP fee-for-service program claims submission. In addition, Medicaid bulletins and Remittance and Status (R&S) banner messages provide up-to-date claims filing and payment information. The R&S banner messages, and the TMPPM are all available on the TMHP website. Service codes are located on the TMHP website. Fee-for-service claims are processed by TMHP. The following services are covered under FPP:
A. Annual family planning and preventive healthcare visit;
B. Pregnancy testing and counseling;
C. Contraceptive services, all methods except elective abortion and emergency contraception, including necessary follow-up and surveillance; and
X. Xxxxxxx health screening and diagnostic services, as indicated:
1. Screening and diagnosis of cervical cancer
2. Limited treatment of cervical dysplasia
3. Breast cancer screening and diagnosis
4. Screening and treatment for sexually transmitted diseases and infections (STD/STI)
5. HIV screening
6. Limited prenatal care services
7. Recommended immunizations
8. Screening for postpartum depression
9. Diabetes screening 10. Hypertension screening 11. Screening for elevated cholesterol 12. Preconception health (e.g. screening for obesity, smoking, and mental health)
Fee-for-Service Funding. The fee-for-service payment method is based on the approved service code used with acceptable submission of all required documentation, forms, and/or reports. Grant recipients will be reimbursed using the fee-for-service reimbursement method by submitting claims to BCCS Med-IT for direct clinical care services provided to Clients, which will then be paid by HHSC. Service codes are located in Attachment B, BCCS Billing Guideline.
Fee-for-Service Funding. Fee-for-service claims are not funded under this RFA. This RFA is for a cost reimbursement award to provide services detailed in Section 2.2.
Fee-for-Service Funding. The funding for Services in Schedule B, attached hereto and incorporated by reference herein, is a Fee for Service Agreement. The Mental Health Board will pay the authorized cost set forth in Schedule B which is supported by authorized activity codes set forth in the approved Work Plan and documentation required to be submitted with the Affidavit, so long as the Services are provided for or to a Dundee Township resident (as determined in Section 4). The Provider is responsible for submitting Affidavits in accordance with applicable rates and Mental Health Board shall not allow Affidavit resubmissions beyond 180 days unless approved by the Mental Health Board. The Mental Health Board will not pay for services rendered beyond the maximum dollar amount set forth in Schedule B. Provider must first seek payment from all other potential payers prior to billing the Mental Health Board for Services. The Provider agrees to and shall maintain sufficient documentation to show payment from all outside funding sources. The Mental Health Board shall be billed using CPT codes, HCPCS codes or Mental Health Board activity or service codes as identified in the Work Plan(s). Subject to approval in the Work Plan, notwithstanding any terms to the contrary, Services shall be provided and billed in alignment with the Illinois Department of Human Services (hereinafter Department of Human Services) requirements for Medicaid Reimbursement under 59 Illinois Administrative Code Part 115, Part 116, Part 117, Part 119, Part 120, Part 132, and Part 140, 77 Illinois Administrative Code Part 2060 and Part 2090, and the Mental Health and Developmental Disabilities Confidentiality Act unless otherwise approved.
Fee-for-Service Funding. Deleted: s
Fee-for-Service Funding. The funding for Services in Schedule B, attached hereto and incorporated by reference herein, is a Fee for Service Agreement. The Mental Health Board will pay the authorized cost set forth in Schedule B which is supported by authorized activity codes set forth in the approved Work Plan and documentation required to be submitted with the Affidavit. The Mental Health Board is not obligated to pay for units in excess of the maximum number set forth in Schedule B. The Mental Health Board is not obligated to pay for Services provided to a client who qualifies for full or partial payment from another funding source, public or private. The Provider must maintain sufficient documentation to show coordination of benefits and eligibility of funding under this Agreement. The Mental Health Board will be considered the payor of last resort and Provider will first seek payment from other payors in all cases where allowed under federal and state law unless the Provider and the Mental Health Board have expressly agreed in writing to alternative funding arrangements. In no event will Provider be allowed to xxxx and collect payment from the Mental Health Board and another payor for the same Service. The Mental Health Board shall be billed using CPT codes, HCPCS codes or MHB specific codes as identified in the Work Plan(s). Subject to approval in the Work Plan, notwithstanding any terms to the contrary, Services shall be provided and billed in compliance with the Illinois Department of Human Services (hereinafter Department of Human Services) requirements for Medicaid Reimbursement for the Developmental Training Program or under Illinois Rule 132 Medicaid Rehab Option or under DASA Rule 2060 and 2090 if applicable.
