Update on DMAS-122 Initiative

VHCA (2/20/2009)

This information was provided in a Medicaid Memo recently sent to providers by the Department of Medical Assistance Services (DMAS).  It is our understanding that a second memo will be sent by the end of February providing additional technical guidance on using automated resources to verify patient pay information.  One key component of the DMAS-122 automation initiative is being postponed; the link between patient pay information and the online DMAS billing database.  VHCA will continue to work with DMAS staff to push for the implementation of this important feature.  DMAS has provided responses to a list of questions related to the upcoming changes.

Effective March 1, 2009, implementation of the electronic patient pay process will begin. Local departments of social services (LDSS) will be required to enter data regarding an individual’s patient pay obligation into the Medicaid Management Information System (MMIS) at the time action is taken on a case either as the result of an application, redetermination of eligibility, or reported change.

Verification of an individual’s patient pay obligation will be available through the web-based ARS system and telephone-based Medicall system. Nursing facilities should begin transition to the electronic process on the first of March. Within 12 months, all patient pay info will be entered into MMIS and once the MMIS electronic patient pay process is fully implemented, the LDSS will no longer advise providers of patient pay obligations for enrollees.

Use of the DMAS-122 form by providers and LDSS staff will cease to be effective on March 1, 2009, as the form will be obsolete at that time. For communication of information other than patient pay, a new communication form has been created. The Medicaid LTC Communication Form (DMAS-225) will be available here early next week.  In the interim, a draft of the new form is available on the VHCA website.

DMAS offers a web-based Internet option (ARS) to access information regarding Medicaid or FAMIS eligibility, claims status, check status, service limits, prior authorization, and pharmacy prescriber identification. Click here for the internet address to use to enroll for access to this system. The MediCall voice response system will provide the same information and can be accessed by calling 800.884.9730 or 800.772.9996. Both options are available at no cost to providers.