The 6780 Medicaid Crossover form will be discontinued upon Go-Live of the MITS (Medicaid Information Technology System) Web Portal.
• The information formerly entered on this form should be entered in the new MITS Web Portal using the “Other Payer” panels.
• Medicare and commercial payer information can be entered using this entity, including payment amounts and adjustment reason codes.
• You can enter up to 50 claims per day / per provider. Once you reach this limitation, you will receive the following message: “May not exceed 50 new claims per day, per Provider ID. New claims must wait until next day - reached daily maximum per Provider ID.”
No go-live date has been announced yet. Once it is determined that this system is fully functional, they will complete implementation.
What to know when MITS (Medicaid Information Technology System) goes live:
• Providers can obtain an unlimited number of claims status reports, including status reports for claims more than two weeks old.
• Claims status checks may be performed 24/7,eliminating the need to call the Medicaid provider hotline.
• Eligibility and claims data are in “real time.”
MITS claims will accept the following modifiers when appropriate:
• Left/right modifiers – LT (left side) and RT (right side) – will be allowed on surgery and specific diagnostic and therapeutic codes. They will not be allowed on codes for radiology procedures or orthotics/prosthetics.
• Site modifiers – E1-E4 (eyelids); FA and F1-F9 (fingers); TA and T1-T9 (toes); and LC, LD and RC (coronary arteries) – will be allowed on surgery and specific diagnostic and therapeutic codes. They will not be allowed on codes for radiology procedures.
• Modifier 25 will be used with evaluation and management (E&M) codes and affecting adjudication in select circumstances only.
Paper prior authorizations will no longer be accepted. All prior authorization requests must be done using the portal.
ODJFS will discontinue the usage of the TCN (transaction control number). They will begin using an ICN (internal control number) in place of this. The ICN will be 13-digits, instead of the original 17-digits used with the TCN.
No changes to the process of receiving EFTs.
EDMS (Electronic Document Management System) cover sheet is required when mailing documentation that was unable to be downloaded to the web portal. The acceptable file formats are gif, tiff, bmp, jpg, ppt, doc, xls, pdf, txt and mdi.