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Claims and Compliance Update



COMPLIANCE HOTLINE

EFFECTIVE IMMEDIATELY DWMHA Corporate Compliance Advisory Committee announces the implementation of a COMPLIANCE HOTLINE # - (313) 833-3502.

Integrated Care Alliance Hotline (866) 606-3889



Claims Reminder

Claims Reminder

Leave of Absence (LOA) 3806 Log
When completing the Leave of Absence Log, please ensure that hospital is identified with a “H”.  Remember, when a consumer is on a Leave of Absence or in the Hospital, services are not to be billed. If services such as Skill Building are occurring before/after the Leave of Absence time frame, please identify in the comment section of the claim. (I.e. consumer attending Skill Building and returned to LOA status)

If a consumer is on Leave of Absence and had 1:1 staffing before leaving, identify it as E- Enhanced Staffing/2- LOA on the Leave of Absence (LOA) 3806 Log.

E/2 = 1:1 staffing & Leave of absence (LOA) on the same day.

Community Living Support Staff / Hospital Stay
Integrated Care Alliance will not pay for staffing for individuals admitted to the hospital for medical or psychiatric care.

Integrated Care Alliance will pay for one-to-one staffing when individuals are transported to hospital Emergency Departments. We will continue payment through the course of Emergency treatment when deemed appropriate and necessary.

Once the hospital admits the individual for care, payment for staffing discontinues.



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Recipient Rights
707 W. Milwaukee Avenue
Detroit, MI 48202
Phone: 313-344-9099 or
313-833-2500
Fax: 313-833-2156
TDD Line 800-630-1044
 
 
 
Last update: 5/25/2016 Privacy Statement