Posted by Behavioral Health Billing Solutions, LLC.
Registration is open for ALL Behavioral Health Providers including Enrollment of Dependently Licensed and BH Paraprofessional Practitioners in MITS.. MITS BITS is available here.
New information in the MITS BITS may provide guidance on the selection of a taxonomy code for providers. See below for more info from Medicaid that is included in the release.
Appendix A – Tips on selecting a taxonomy code on the NPPES site:
In choosing the taxonomy code we suggest that paraprofessionals review the following categories:
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Behavioral Health and Social Service Providers, or Other Service Providers
Taxonomy codes are self-selected by the health care practitioner and describer the health care provider’s work activities plus any required education, licensure and/or certification.
For example:
Case manager (taxonomy code 171M00000X) is “a person who provides case management services and assists an individual in gaining access to needed social, educational, and/or other services.” etc.
Peer specialist (taxonomy code 175T00000X) is an “individual certified to perform peer support services through a training process defined by a government agency, such as….a state mental health department/certification/licensing authority.”
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Practitioners, such as qualified mental health workers may not find their practitioner type on the list of the Health Care Provider Taxonomy codes. If this is the case, they may choose a taxonomy code that links to the work of the organization that employs them.
For example:
Mental Health clinic, including a community mental health center (taxonomy code 261QM0801X) or Community/Behavioral Health agency (taxonomy code 251S00000X).
Qualified Mental Health workers are encouraged to review the activity descriptions for the taxonomy code associated with their employer. If that information is not available, the worker can access the NPPES system and search the database using the provider’s National Provider Identifier where the taxonomy code will be found.
Reminder, this all pertains to the changes coming July 1st, 2018. SEE BELOW.
Beginning with dates of services July 1, 2018, Medicaid behavioral health claims will no longer use the U and H modifiers to identify these types of practitioners. Instead, claims will be required to contain the National Provider Identifier (NPI) for these practitioners in the rendering field of the claim. See Appendix A below for tips on selecting a National Plan and Provider Enumeration System (NPPES) taxonomy code for behavioral health paraprofessionals.
The practitioners listed in the chart in the MITS BITS above must be actively enrolled with Ohio Medicaid and affiliated with their employing/contracting agencies by July 1, 2018 in order for claims to process. The chart includes the documentation that must be provided with the application for each category of practitioner.
***Please note: claims for services between January 1, 2018 and June 30, 2018 should not include these practitioners’ NPIs in the rendering field. Claims will deny if this is done.
Appendix B identifies some of the common reasons why applications are returned for additional information. Questions regarding the enrollment of dependently licensed and BH paraprofessional staff may be sent to MEDICAID_PROVIDER_UPDATE@medicaid.ohio.gov or by calling 1‐800‐686‐1516 (IVR) and choosing option 2.
Multi‐credentialed/paraprofessional practitioners
If a practitioner has more than one credential/paraprofessional recognition, please include a comment in the Notes section of MITS enrollment application indicating what additional credential or paraprofessional recognition is held.
Paraprofessionals have the ability to select a primary, a secondary or multiple secondary specialties. Be certain to upload the necessary documentation for each license/certificate.
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We know that the ratio of independent to dependent/para-professional providers for most agency’s on average is between 10-20% independent and 80-90% dependent or paraprofessional.
This means adding a substantial burden on agency’s to register ALL providers by July 1st.
Behavioral Health Billing Solutions offers a start to finish registration process for your providers. Please call 614-395-0136 or email Teresaheim@bhbillingsolutions.com on how we can assist in making this substantial undertaking an efficient process for your agency. More details are provided here.
Contact us today to utilize experts that will ensure your providers are registered correctly.