FREQUENTLY ASKED QUESTIONS on provider billing
1You can bill the recipient only under the following circumstances:
• If the service provided is not covered by Medical Assistance and you have notified the recipient prior to providing the care that the service is not covered; or
• If the EVS reported a message that the recipient is not eligible for Medical Assistance on the date you provided services.
2. Can a provider bill Maryland Medicaid recipients for missed appointment?
No. Federal policy prohibits providers from billing Medicaid recipients for any missed appointments. To obtain a copy of the transmittal (MCO #52) that explains this policy, visit www.state.md.us/mma/providerinfo.
3. Where can a provider call to check the status of claims?
Provider Relations is available Monday-Friday to assist providers with questions regarding the status of claims. To reach a representative, call 410-767-5503 or 1-800-445-1159 between 8:00 am – 5:00 pm.
4. Where can a provider obtain a copy of a Remittance Advice (RA)?
Copies of RAs are available for up to two years by accessing the Program’s website at www.emdhealthchoice.org. eMedicaid registration must be completed by an Administrator. To request an eMedicaid brochure, please call the Provider
Training and Liaison Unit at 410-767-6024. To obtain copies of RAs older than two years, you may call a representative at (410) 767-5503 between the hours of 8:00 a.m. – 5:00 p.m.
5. How can a provider request a check tracer?
You may call Provider Relations (410) 767-5342 between the hours of 8:00 am to 4:30 pm.
6. How can a provider request training for paper billing?
The Provider Training and Liaison Unit provides quarterly trainings to Maryland Medicaid providers. To register for the training, call 410-767-6024 or go to www.dhmh.state.md.us and click on Provider Training to view the schedule and
registration form.- 19 –
7. Can you check EVS for future dates?
No, however you can check EVS for past eligibility up to one year.
8. How long does a provider have to file a claim?
A provider has nine months from the date of service to submit a claim for payment. For other time statutes, see page two.
9. Claims should be mailed to what address?
Claims Processing
P.O. Box 1935
Baltimore, MD 21203
10. How long should I wait before I check claim status?
Under normal conditions, if you have sent a paper claim, wait six weeks before calling Provider Relations.
1You can bill the recipient only under the following circumstances:
• If the service provided is not covered by Medical Assistance and you have notified the recipient prior to providing the care that the service is not covered; or
• If the EVS reported a message that the recipient is not eligible for Medical Assistance on the date you provided services.
2. Can a provider bill Maryland Medicaid recipients for missed appointment?
No. Federal policy prohibits providers from billing Medicaid recipients for any missed appointments. To obtain a copy of the transmittal (MCO #52) that explains this policy, visit www.state.md.us/mma/providerinfo.
3. Where can a provider call to check the status of claims?
Provider Relations is available Monday-Friday to assist providers with questions regarding the status of claims. To reach a representative, call 410-767-5503 or 1-800-445-1159 between 8:00 am – 5:00 pm.
4. Where can a provider obtain a copy of a Remittance Advice (RA)?
Copies of RAs are available for up to two years by accessing the Program’s website at www.emdhealthchoice.org. eMedicaid registration must be completed by an Administrator. To request an eMedicaid brochure, please call the Provider
Training and Liaison Unit at 410-767-6024. To obtain copies of RAs older than two years, you may call a representative at (410) 767-5503 between the hours of 8:00 a.m. – 5:00 p.m.
5. How can a provider request a check tracer?
You may call Provider Relations (410) 767-5342 between the hours of 8:00 am to 4:30 pm.
6. How can a provider request training for paper billing?
The Provider Training and Liaison Unit provides quarterly trainings to Maryland Medicaid providers. To register for the training, call 410-767-6024 or go to www.dhmh.state.md.us and click on Provider Training to view the schedule and
registration form.- 19 –
7. Can you check EVS for future dates?
No, however you can check EVS for past eligibility up to one year.
8. How long does a provider have to file a claim?
A provider has nine months from the date of service to submit a claim for payment. For other time statutes, see page two.
9. Claims should be mailed to what address?
Claims Processing
P.O. Box 1935
Baltimore, MD 21203
10. How long should I wait before I check claim status?
Under normal conditions, if you have sent a paper claim, wait six weeks before calling Provider Relations.