We’ve made updates to the Provider Manual for December 2020, and the changes are listed below for your reference.
Claim Submission
- Timeframe for Claim Submission
Documentation
- Evaluation and Management (E/M)Documentation Requirements
Documentation Removed –(Information is now available through the Availity Provider Portal)
- Documentation Guide for InterQual– Behavioral Health
- Behavioral Interventions for the treatment of Autism
- Child Psychiatric Residential Treatment Program
- Psychiatric Partial Hospital Program
- Substance Use Disorder Residential Treatment Program
- Substance Use Disorder Partial Hospital Program
- Adult Psychiatric Residential Treatment Program
Reimbursement & Billing Guidelines
The following chapters have been updated or relocated due to new reimbursement policies or notices.
- All Patient Refined – Diagnosis Related Groups (APR-DRG)
- Acute Inpatient (APR-DRGS) Hospital Billing
- Behavioral Health Inpatient Acute (APR DRGS) – Institutional Billing
New chapter additions
- Enhanced Ambulatory Patient Group(EAPG)
See the updates and other provider information
- View the updated Provider Manual
- See reimbursement policies on our website
View reimbursement notices in the fee schedule portal