how to use dde professional billing for alternative care providers

How to Use DDEProfessional Billing

for Alternative Care Providers

How to use DDE:Professional Billingfor Alternative Care

• Go to www.medicaid.state.ar.us• Click on “Provider”• Click on “Log on”• Enter the provider’s 9-digit Medicaid

ID number (PIN) as the User ID– The setup password is the provider’s SSN

(will be prompted to change)

• Click the Submit button


Log On

http://www.medicaid.state.ar.us/

Once you are logged on, your provider name will appear under “Welcome Back”.

To start a new claim, click on “Professional Claim”.

To void or adjust a previous claim, click on “Professional Claim reversal”.


Header: Submitter Information


• Entity Type– Enter person

• Last/Organization Name/First Name– Enter the Provider last and first name

• Electronic Transmitter ID– Enter eight zeroes: 00000000

• Name/Telephone number– Enter your name and phone number,

including area code


Submitter


Header: Billing Provider

• Medicaid Provider ID/NPI– Enter the provider’s Medicaid ID number and

leave the NPI field blank


Billing Provider


Header: Subscriber Information

• Enter the beneficiary’s information– Last Name– First Name– Middle Name (not required)– Medicaid beneficiary ID number– Address, including City, State, Zip– Birth Date

• Format is MMDDYYYY• If DOB is 01/01/2010, enter 01012010

– Gender


Subscriber


Header: Claim Information

• Patient Account Number– 12345

• Place of Service– Place of service - Enter 12


Claim Information


Header: Diagnosis Codes

• Principal Diagnosis Information – Enter the primary diagnosis code – Do not include the decimal– Example: If DX is 111.11, enter 11111

• Other Diagnosis Information– Enter additional diagnosis codes if applicable


Diagnosis Codes


Services: Add Service to Claim

• Procedure– Enter S5125

• Charge – The dollar amount that you are billing. Using

the Pay Grid that follows, enter the Billing Amount for the hours you worked.

• Quantity– Units of time that you worked. Using the Pay

Grid that follows, enter the Units Worked for the hours you worked.

• Diagnosis Code Pointer– Enter 1


Add Service to Claim

Pay Grid

Hours Worked(15 min. increments)

Units Worked Billing Amount(Units X $2.43)

15 mins 1 $2.43

30 mins 2 $4.86

45 mins 3 $7.29

1 hr 4 $9.72

1 hr, 15 mins 5 $12.15

1 hr, 30 mins 6 $14.58

1 hr, 45 mins 7 $17.01

2 hrs 8 $19.44

2 hrs, 15 mins 9 $21.87

2 hrs, 30 mins 10 $24.30

2 hrs, 45 mins 11 $26.73

3 hrs 12 $29.16

3 hrs, 15 mins 13 $31.59

3 hrs, 30 mins 14 $34.02


Use this table to complete your AAS-9559. Find the hours you work at one time. Then enter the Units Worked and the Billing Amount on the AAS-9559.

Example: You work 2 hours and 15 minutes one day. On the AAS-9559, enter 9 units worked and $21.87 for the billing amount.

Pay Grid


Hours Worked(15 min. increments)

Units Worked Billing Amount(Units X $2.43)

3 hrs, 45 mins 15 $36.45

4 hrs 16 $38.88

4 hrs, 15 mins 17 $41.31

4 hrs, 30 mins 18 $43.74

4 hrs, 45 mins 19 $46.17

5 hrs 20 $48.60

5 hrs, 15 mins 21 $51.03

5 hrs, 30 mins 22 $53.46

5 hrs, 45 mins 23 $55.89

6 hrs 24 $58.32

6 hrs, 15 mins 25 $60.75

6 hrs, 30 mins 26 $63.18

6 hrs, 45 mins 27 $65.61

7 hrs 28 $68.04

7 hrs, 15 mins 29 $70.47

7 hrs, 30 mins 30 $72.90

7 hrs, 45 mins 31 $75.33

8 hrs 32 $77.76


Services: Service Date/NDC Info

• Service Date Period (first day worked)– Enter the From and To date of service – (1

day) – same date– Format is MMDDYYYY – If the date of service is 1/1/2010, enter

01012010– Click Add


Services: Service Date/NDC Info

Services: Adding the Service


• Once you click the Add button, it will add your service to the top of the screen

• Once you have added the service, you can add a second service, third service, etc.

• Click Submit


Adding Service (Additional Days) on Claim/Submit Claim

how to use dde professional billing for alternative care providers

Documents