DMAS Patient Pay Update

VHCA (4/3/2009)

As previously reported, the Medicaid Patient Information form (DMAS-122) is obsolete as of March 1, 2009.  For communication of information other than patient pay, providers, the local Departments of Social Services (LDSS) and the Department of Medical Assistance Services (DMAS) are now using the new Medicaid LTC Communication Form, DMAS-225.  An updated question and answer document addressing the DMAS-225 is now available.

Providers were previously instructed that they must monitor either the ARS or Medicall systems for Medicaid LTC enrollees in order to determine the appropriate amount of patient pay to collect.  DMAS staff recently met via conference call with nursing facility representatives and has provided a third option for facilities to obtain patient pay information. 

Facilities with electronic data interchange (EDI) capability may make arrangements with DMAS contactor First Health to allow for the ability to request patient pay status on up to 99 residents at a time.  Facilities interested in this option should telephone the First Health helpdesk at 800.241.8726 and advise the representative they are interested in the 270/271 Inquiry using EDI.  Facilities will need to indicate if they currently use EDI software and be able to provide technical specifications about the software in use.