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SPSI

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2019 News Items

August 01, 2019

Court Ordered Evaluation Project Deployment

August 1, 2019
 
Court Ordered Evaluation (COE) Project Deployment
 
SPSI would like to remind our clients who perform COE services that the new process for handling court-ordered evaluation and pre-petition screening claims for Mercy Care RBHA begins today. There are several important technical points to note regarding the submission of these claims:
 
  • COE services cannot be combined with non-COE services in the same claim.
  • COE modifier/condition code must be used on all claims as seen below:
  • Professional: Modifier '32' is expected on the CPT/HCPCS code related to COE services and may occur in any position
  • Institutional: Condition code 04 is expected (Loop2300, HI101, 'BG^04')
 
SPSI will separate claims with these modifiers or condition codes to send to a separate portal at Mercy Care for adjudication. The modifier and condition codes will be sent to Mercy as received (they will NOT be stripped from the claim). It is not necessary to send COE claims in a separate 837 file to SPSI.
 
Mercy will return a hybrid 277 claim status response file with adjudication information that SPSI will make available to our clients.
 
Thank you for your attention to this important notice. Please contact Mercy Care or SPSI for additional information regarding this change.
 
Sincerely,
 
Your SPSI Arizona Team
Southwestern Provider Services, Inc. (SPSI)

Link to original message:  
https://conta.cc/2T32izx

June 04, 2019

Care 1st to Wellcare transition delayed


"Care 1st previously communicated that we would integrate into our Parent Company, WellCare Health Plans. This integration was to include systems and platform changes along with a brand name change.
Please be advised that the integration has been postponed for Care1st!
Please continue to use Care1st existing processes and systems. The following page provides additional details/clarification."

Link to Full Notice:

Care1st Medicaid Plan (AHCCCS) Migration to WellCare Postponement

 

May 24, 2019

Mercy Care Timely Filing Reduction

In case you missed it, Mercy Care has changed their policy regarding timely filing requirements for claims submission (Mercy Care will be reducing its timely filing editing from 180 to 150 days from date of service, to be implemented on July 1, 2019). Please be aware of this important change and read the detail from Mercy Care's notice on 5/23/19.
 

May 02, 2019

Payer ID change: Steward ACC plan and HCIC RBHA

As of 10/1/2018, providers should be using 62179 as the payer ID for both the Steward HC ACC plan as well as the HCIC RBHA.

Read the full details here

March 08, 2019

SPSI Arizona Has Moved

SPSI's Arizona office Has moved!
 
A quick notice to all our valuable clients that SPSI's Arizona office moved on Wednesday, 2/27 and with the new office comes new phone numbers:
 
  • Troy: 480.534.5713
  • Josh: 480.534.5781

Southwestern Provider Services, Inc.

2350 Airport Freeway, Suite 410, Bedford, TX 76022

817-684-8500 - Office