Oregon Medicaid transferring to a new MMIS system

The replacement of Medicaid Management Information System (MMIS) is going live December 9th 2008. This new change will have an effect on how claims are submitted and how doctors are paid on medical claims. They have also added additional tools to speed things up and make it easier on all parties (medical offices, billing services, clearinghouses etc).

For clients that use RelayHealth as your clearinghouse to submit claims electronically to CPID#s 1481 & 5517 for Oregon Medicaid please be aware of these new updates:

• RelayHealth is submitting the last electronic file to Oregon Medicaids current sysetm up to November 28th 2008
• Claims will be held by RelayHealth if submitted between November 28th - December 8th 2008
• On December 9th 2008 RelayHealth will send their first file to the NEW Oregon Medicaid MMIS claim processing system

Providers already approved with EDI Agreements thankfully do not need to re-register; however any new providers do require completed EDI Agreements in order to transmit claims electronically.

Providers that want to be setup with Electronic Remittance Advice (ERA) are required to complete a EDI Agreement for eRemittance. Anyone currently setup with ERA through RelayHealth will not be required to re-credential for this feature.

Please take a few minutes to register with MMIS training which is available online and can be found by visiting www.oregon.gov/DHS/mmis/training-info.shtml

A web-based provider eCourse is available through the DHS learning Center (select course C00818)

My recommendations is to watch claims closely for the first month. With anything this major in changing software be ready for Bugs. Be patient but also be ready to drop claims to paper if their are any issues with electronic claims files.

Another idea is to hold on to all claims from November 28th - December 15th and then submit. This will give both parties (RelayHealth and MMIS) to identify any bugs and fix them. This also means you won't have your claims involved with any mishaps.

If they do have problems with transmissions do not be afraid to press the Rebill button.

Happy Billing and Collecting!

Confused by Electronic Medical Claim billing then read these articles on Billing Health Insurance medical claims

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