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Noridian JE Implementation Website Launch

Mon, 2013-05-20 12:38

Noridian is the new Medicare Administrative Contractor (MAC) for Jurisdiction E (JE) – formerly Jurisdiction 1; California, Hawaii, Nevada (transition date 9/16/2013). As they begin the process of implementing the JE workload, they want to inform you of important changes that may impact you. Their objective is to make the fewest changes possible in order to allow for a smooth implementation. Noridian will continue to be adding many more features and articles in the coming weeks to the website.

NAS Changes Name to Noridian Healthcare Solutions (Noridian)

Mon, 2013-05-20 12:35

Effective May 13, 2013 Noridian Administrative Services (NAS) has officially changed its name to Noridian Healthcare Solutions (Noridian) to better reflect the scope of capabilities that have grown from their core business.

MAC JF for Arizona, Alaska, Idaho, Oregon, Montana, North Dakota, South Dakota, Utah, Washington, Wyoming for Part B  and Minnesota for Part A. Future MAC JE for California, Hawaii and Nevada.

Independent Laboratory Billing for Pathology Services

Thu, 2012-10-25 11:55

Effective for dates of service on and after January 1, 2013, the Agency will discontinue separate payment to independent laboratories for the technical component of pathology services. The Agency expects independent laboratories to bill hospitals for the technical component of anatomic pathology services furnished to hospital inpatient and outpatient clients.  To prevent duplicate payment, the Agency will not pay independent laboratories, if they bill Medicaid for these services.

New Medicaid Requirements for Ordering, Referring and Prescribing Providers

Mon, 2012-07-23 17:00

Enforcement of the previously published notice related to ordering, referring or prescribing providers has been delayed until August 1, 2012. Effective for dates of service on and after August 1, 2012, the Medicaid Program of the Health Care Authority (HCA) will require any ordering, referring, or prescribing providers to be enrolled as participating providers with Medicaid.

New Medicaid-only National Correct Coding Initiative (NCCI) effective July 1, 2012

Wed, 2012-05-23 17:00

CMS will implement a new Medicaid-only National Correct Coding Initiative (NCCI) effective July 1, 2012. Washington State Health Care Authority (HCA) plans to enforce and comply with the new NCCI edits. CMS has developed Medicaid-only NCCI edits for services that may be covered by the Medicaid program, but not the Medicare program. Files containing the new Medicaid-only NCCI edits can be found here:

New Medicaid Requirements for Ordering, Referring, and Prescribing Providers

Wed, 2012-05-23 17:00

Effective for dates of service on and after July 1, 2012, the Medicaid Program of the Health Care Authority (HCA) will require any ordering, referring, or prescribing providers enroll as participating providers with Medicaid. Medicaid cannot pay for any health care service requiring a referral, order, or prescription from a physician or other licensed health care professional unless the provider is enrolled in HCA’s ProviderOne claims adjudication system.

New Medicaid-only National Correct Coding Initiative (NCCI) effective July 1, 2012

Wed, 2012-05-23 17:00

CMS will implement a new Medicaid-only National Correct Coding Initiative (NCCI) effective July 1, 2012. Washington State Health Care Authority (HCA) plans to enforce and comply with the new NCCI edits. CMS has developed Medicaid-only NCCI edits for services that may be covered by the Medicaid program, but not the Medicare program. Files containing the new Medicaid-only NCCI edits can be found here:

New Medicaid Requirements for Ordering, Referring, and Prescribing Providers

Wed, 2012-05-23 17:00

Effective for dates of service on and after July 1, 2012, the Medicaid Program of the Health Care Authority (HCA) will require any ordering, referring, or prescribing providers enroll as participating providers with Medicaid. Medicaid cannot pay for any health care service requiring a referral, order, or prescription from a physician or other licensed health care professional unless the provider is enrolled in HCA’s ProviderOne claims adjudication system.

ProviderOne to start updating license information effective January 23, 2012

Mon, 2012-01-30 16:00

As of January 23, 2012, ProviderOne will automatically update professional, pharmacy, and hospital license information from an interface with the Washington State Department of Health (DOH) for all Washington State providers. The license information will be retrieved directly from the DOH on a daily basis and will update license information in ProviderOne. Shortly after the license update process begins in ProviderOne, claims will begin to deny for expired licenses.

Lab Authorization Changes

Mon, 2011-10-31 17:00

Retroactive to dates of services on and after October 1, 2011, the Agency has changed the following procedure codes from noncovered to covered with PA: Procedure Code Description
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