The Academy of Senior Health Sciences, Inc. (formerly The Ohio Academy of Nursing Homes, Inc.) seeks to provide public education and awareness initiatives to the long-term care community in Ohio. Our membership represents a true cross-section of the skilled nursing facility profession, from small sole proprietorships to larger Ohio-based multi-facility companies, as well as those businesses that service our industry. Through our public education and awareness efforts, the Academy brings the collective influences of the members together into a single voice on vital issues affecting our profession.
Founded in 1966, the Academy then identified one of its core purposes as "To foster a spirit of goodwill among those persons engaged in the nursing home industry, to promote ethical practices in their relationships with each other, their employees, and the general public to the end that all interests may be served fairly..." Though the organization has undergone several transformations over the years, most notably in 2011, its dedication and commitment to Ohio's most frail and elderly remains the same.
| The Academy Weekly Headlines from 2 Weeks Ago|
ODH provides RCF tag to code cross walk
The Ohio Department of Health has provided The Academy and other interested parties with an updated cross walk of the tags and corresponding OAC/ORC. The document, in MS-Word format, can be downloaded by clicking here.
Molina provides corrected claims filing, training info in latest provider newsletter
Molina provided information on changes to the requirements for filing corrected claims effective April 1. In their latest provider newsletter, Molina notes: "Effective April 1, 2018, corrected claims must be submitted with the Molina Healthcare claim ID number of the original claim being corrected, and with the appropriate corrected claim indicator based on claim form type. Corrected claims received without this information will not be accepted and will receive the following denial information on the Molina Healthcare remittance:
Submission of Final Claims after Interim Billing: Also effective April 1, 2018, inpatient facility claims billed on a UB claim form, bill type 0117 will no longer be accepted as the final original claim. Facilities which have submitted interim claims should submit a final claim upon patient discharge using the 0111 bill type.
- Category Code A3
- Status Code 748
- Entity Code 41
- Error Description: "Missing incomplete/invalid payer claim control number"
Please Remember: Corrected claims are used to change or add information to a previously submitted claim. Corrected claims are not adjustments and should be sent through the original claim submission process with a corrected claim indicator and Molina Healthcare claim ID number as outlined in the Corrected Claim Billing Guide.
When submitting attachments through the Provider Portal:
- Submit electronically with payer ID 20149 or on the Provider Portal.
- Include all elements that need correction and all originally submitted elements
- Do not submit only codes edited by Molina Healthcare
- Do not submit via the claims reconsideration process
- Do not submit paper corrected claims
Corrected claims must be received by Molina Healthcare no later than the filing limitation stated in the provider contract or within 120 days of the original remittance advice."
Molina Healthcare is also now offering monthly training sessions:
- Supported file formats are PDF, TIFF, JPG, BMP and GIF
- Only 1 file is allowed per claim
- If a file exceeds 128 MB an alert will be sent and the claim will not process. For files that exceed 128MB contact your Provider Representative for submission alternatives.
Provider Portal Training:
- Provider Portal: These sessions cover administrative tools, member eligibility, authorization requests, HEDIS® profiles and more!
- Provider Claim Submission: Learn to use the Provider Portal to submit claims, check claim status, add supporting documents, request claim reconsiderations and more!
Claim Submission Training:
- Thurs., March 22, 2 to 3 p.m. meeting number 808 301 312
- Thurs., April 26, 2 to 3 p.m. meeting number 805 367 064
Click "Join" at WebEx.com or call (855) 655-4629 and follow the instructions. Meetings do not require a password.
- Tues., March 27, 1 to 2 p.m. meeting number 801 964 832
- Tues., April 24, 1 to 2 p.m. meeting number 804 281 323
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