SCHA Provider Questions and Answers
Latest Provider Updates
Apr. 28, 2010 Primary Care Clinic Accessibility Survey starts May 1st. Read more...
Mar. 30, 2010 $75k available for Rural Health Collaborative Pilot Grants. Download .pdf
Mar. 30, 2010 Mar.-Apr.. issue of Provider Network News. Download .pdf
Jan. 28, 2010 Provider Bulletin on Maternal Depression Screening. Download .pdf
Jan. 28, 2010 Jan.-Feb. issue of Provider Network News. Download .pdf
Nov. 16, 2009 New Provider Incentive for Lead Testing. Read more...
Nov. 4, 2009 Electronic Claim Submission Notice. Download...(.pdf)
Nov. 4, 2009 Chemical Dependency Program Claim Submission update. Download...(.pdf)
Sept. 24, 2009 The September-October edition of "Provider Network News" is hot off the press. Read more...(.pdf)
Aug. 3, 2009 South Country Health Alliance is now part of the Minnesota Credentialing Collaborative (MCC). Read more...(.pdf)
July 23, 2009 The July-August 2009 issue of "Provider Network News" is released (.pdf)
May 27, 2009 Sign up online to receive provider updates and SCHA's monthly provider newsletter "Provider Network News" direct to your email inbox
Mar. 30, 2009 SCHA is providing the following disease management programs for members: heart condition, diabetes, and asthma. Read more on the new Disease Management Programs page.
Questions and Answers: Nursing Home Communication Question and Answers Bulletin 1-5-09 (.pdf)
Questions and Answers from Provider Education Sessions, covering the following topics (download .pdf):
- Eligibility
- Prior Authorization
- DME
- Billing
- EDI
- Mental Health & Chemical Dependency
- PCA
- Credentialing & Contracting
Question and Answers Regarding the Transition from Blue Plus to MMSI, Effective 1/1/2009
Q: Who will South Country Health Alliance (SCHA) be using as the Third Party Administrator (TPA) for 2009?
A: Starting with Dates of Service 1/1/09 SCHA will be using MMSI as the TPA.
Q. How will Inpatient Hospital Room and Board charges be processed when the admission date starts in 2008 and the discharge ends in 2009? Will Blue Plus or MMSI process and pay these claims?
A. For Hospital Inpatient Room and Board claims with an admission date in 2008 and the discharge date in 2009 – the entire claim will be processed and paid by Blue Plus.
Q: Will the physician or ancillary services that occurred during the Inpatient Hospital or Nursing Home stay that over lap 2008 and 2009 be paid by Blue Plus or MMSI?
A: All physician and ancillary services provided in 2008 will be processed by Blue Plus. All physician and ancillary services provided in 2009 will be processed by MMSI.
Q: Who will process and pay the rental of Durable Medical Equipment (DME) claims when the rental date occurred in 2008 but the end date is in 2009?
A: Rental of DME where dates of service started in 2008 and ended in 2009, when the entire service is billed on one claim will be paid by Blue Plus.
Q: Will Home Health Services under the Home Health Prospective Payment System (HH PPS) where episodes begin in 2008 and the discharge is 2009 be process by Blue Plus or MMSI?
A: All HH PPS episode claims that over lap 2008 and 2009, both the RAP and Final claim will be paid by Blue Plus.
Q: How long will the provider have to submit claims for dates of service in 2008 to Blue Plus?
A: Providers must follow the timely filing deadline established by Blue Plus. SCHA and Blue Plus have a one year agreement (1/1/09-12/31/09), to finalize services dates in 2008 to be paid and processed.
Q: What is the address for submitting claims for 2009?
A: Submit paper claims to: MMSI, P.O. Box 4014, Rochester, MN 55903
Q: What is the electronic submission payer ID # for MMSI?
A: MMSI payer ID # 41154.
Q: What phone number do I call for questions about claims?
A: Provider Services call center 1-800-995-4543
Q: Where can I learn more about the services that require authorization and or notification?
A: Providers can access the Prior Authorization/Notification List from our website (www.mnscha.org ) under the Provider Resources tab or from the Provider Manual – (Chapter 13 Medical Services).