DC Medicaid PCA Billing

We have just made available Version 5067 of HHC3000 which includes the ANSI billing changes for DC Medicaid PCA ANSI 5010.  The changes include the NPI of the PCA employee in loop 2310D as required.  When the file is created, each day will be a unique claim.  Being that there could be more than one employee visiting a patient but their system will only allow one employee per claim, we felt this approach would satisfy their requirements.  The situation also complicated by DC Medicaid wanting to show only one record per day even if two or more employees visit the patient on that day.  The employee with the most hours (or first employee if hours are equal) appears with the NPI on the claim.

In order to properly bill for DC Medicaid PCA you will have to go into Insurance / ANSI / Additional Items and check the box labeled “Add 2310D Rendering/Supervising/Employee Loop with NPI (DCMA PCA).”

Changes to the printing of UB04 forms will be made later this week.

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