For your convenience we have compiled a list of the questions most frequently asked about our service. If you can not find a satisfactory answer to your question below, please do not hesitate to call or email us.
Switching to RhinoBill is quick, easy and entirely online! You begin by clicking on any of the "Try it Free for 30 days" buttons on the RhinoBill home page. From there you will complete a series of online forms where you put in your information, agree to our terms, and setup your log in information. This process usually takes about five to ten minutes to complete.
You must have the following information ready when you sign up:
Your Provider ID number
Your NPI number if applicable
SSN or EIN Number (Tax ID)
If you were referred, the RhinoBill username of the person that referred you
Now all you have to do is sign into your newly created account, add your payers, select your procedure codes, create your patient's profile, and start billing!
You do not need to notify ODM or your current billing provider that you are switching in order to start submitting claims with RhinoBill. You will however need to tell your current billing company that you are canceling their services if you don't want to be charged from them anymore!
Rest assured, you will not be required to enter your automatic payment information (credit card, debit card, pre-paid credit card or checking account) until your trial month is over.
You will be able to submit claims immediately. After the sign up process is complete, just log in using the user name and password you created, enter in your payer specific information, create a patient profile and then you can start billing right away!
Before you can begin billing, you’ll need to input the information about the contract you have with your Payer. For this you’ll need:
Your Payer specific Provider Id
The date your contract began with the Payer
What Procedure codes you will be using for your billing
Before you can begin billing, you’ll need to input your patient's information. For this you’ll need:
Name
Address
12 Digit Medicaid Number
Gender
Birthday
Diagnosis Codes (the number that corresponds with your patient's illness or disability aka ICD-10 codes)
Discharge Date (Patient's date they were discharged from the hospital; only valid for 60 days)*
Prior Authorization (6 digit number that is required for special cases; contact your case manager to determine if it is needed)
Ordering/Referring/Prescribing Physicians Name and NPI number*
If your patient's condition was related to an accident and what kind of accident and when*
If your patient has other private insurance, even if it doesn't cover your services*
Payer Type (Commercial, Group, Individual, HMO, etc.)
Claim Type (Commercial)
Company Name
Group Number
Policy Number
Patient's relationship to Policy Holder
Policy Holders Name & Birthday
*Optional information. This may not be required for your patient, talk to your Case Manager or Patient to verify.
No, you do not need to notify anyone in order to start using RhinoBill. ODM only cares that your claims are valid and that they come from an approved EDI trading partner (which of course RhinoBill is). As for your old billing service, you don’t need to cancel with them until you are comfortable using RhinoBill.
The risk-free trial month is completely risk-free! You do not have to cancel your service with your previous billing provider, and you can bill your claims through RhinoBill absolutely free until your trial month is over. If you cancel your RhinoBill service any time during your trial month, you will never be charged.
If you are worried about getting paid in a timely manner, we suggest that you bill only a portion of your claims with us and use your old billing provider for the rest. That way you can compare side-by-side the convenience of RhinoBill with your old billing provider.
RhinoBill is able to be so much less expensive because we designed our business from the ground up to serve the needs of Agencies and Independent Providers who bill ODM for services covered by the Medicaid Waiver. This focus allows us to provide a better quality service at a lower price because it keeps our operations simple enough to allow us to automate many of the tasks that our competitors use their people to do. We let our computers do the hard work so that our people can answer your phone calls and respond to your emails promptly when you have questions or concerns. Unlike some of our competitors, we care a lot about small providers - they are our big customers and it shows! You can always expect friendly and helpful attitudes from our customer service team.
Another added benefit of automating the claim billing process is that your claims will be accurately submitted to ODM. You don’t have to worry about someone at RhinoBill inputing your claim wrong. We send your information over to ODM exactly like you entered it. How’s that for convenience?
If you forget your password, simply click on the "Forgot Your Password?" link on the Log In screen. You will be asked a series of questions to verify your identity. If you successfully answer those questions, a temporary password will be sent to you via email for a one time use. Once you have successfully logged in to the website you will be asked to change your password to a permanent one.
If you are unable to answer the questions you will need to call support.
To change your password, you must be signed into your user account. Once you are signed in, click on the "Account" icon, and then click on the "User/Password" menu item.
If you are not new to RhinoBill and you cannot sign in, you may be using the incorrect user name or password. If this occurs, you will be given an error message. If you attempt to log in to your account too many times with an incorrect password you will be locked out. If this occurs you will need to call support.
You are also not allowed to sign into your account if you have cancelled it. To un-cancel your account and regain access to it, you will need to call support.
To update your information, you must be signed into you user account. Once you are signed in, click on the "Account" icon then, click on the "Provider Info" menu item.
Updating your information with us does not update your information with the State.
Once you are signed in, click on the "Account" icon, then click on the "Cancel" menu item. Once you have done this you will not be able to log into your account again.
If you decide to come back to RhinoBill again you can call support and we will un-cancel your account, and throw in a thumbs up and a smile for free.
Before you can begin billing, you’ll need to input your patient's information. For this you’ll need:
Name
Address
12 Digit Medicaid Number
Gender
Birthday
Diagnosis Codes (the number that corresponds with your patient's illness or disability aka ICD-10 codes)
Discharge Date (Patient's date they were discharged from the hospital; only valid for 60 days)*
Prior Authorization (6 digit number that is required for special cases; contact your case manager to determine if it is needed)
Ordering/Referring/Prescribing Physicians Name and NPI number*
If your patient's condition was related to an accident and what kind of accident and when*
If you patient has other private insurance, even if it doesn't cover your services*
Payer Type (Commercial, Group, Individual, HMO, etc.)
Claim Type (Commercial)
Company Name
Group Number
Policy Number
Patient's relationship to Policy Holder
Policy Holders Name & Birthday
*Optional information. This may not be required for your patient, talk to your Case Manager or Patient to verify.
What is the Payers tab?
The payers tab is where you select the Payers you will be sending your claims for reimbursement.
Independent providers are able to send claims to:
Agency Providers are able to send claims to:
~AmeriHealth
~Anthem
~Buckeye
~CareSource
~Humana
~Molina
~Paramount
~United Healthcare
Managed Care Payers Participating in the MyCare Ohio Plan
~Aetna
~Buckeye
~CareSource
~Molina
~United Healthcare
When creating a claim if you receive this message 'Some service lines have dates that are out of your payer contract period, please adjust them to fit this period' it means the current contract you have for that payer has expired. Simply go to the ‘Payers’ tab and select that payer. You can either select ‘Renew’ and create a new contract or select ‘Edit’ to correct the dates for the current contract.
If you don’t see the procedure code you need check two places. First, your contract in the payers tab. If you do not see the procedure code checked there, check it and press save. Second, check the claim preferences for your patient. If you do not see the procedure code checked here, check it and press save.
A diagnosis code is an alphanumeric code assigned to diseases, illnesses and injuries. It translates your diagnosis into a code that is universal wherever you go.
The ICD-9 code set was implemented in 1979 and there have been many advances in the medical field since then! ICD-10 will now allow for better specification on diagnosis’ since ICD-9 has about 13,000 codes and ICD-10 has about 68,000. Better specification also means improvement in the reimbursement process, identifying certain issues and trends in a community.
The U.S. Department of Health and Human Services has set the effective date as October 1, 2015. What this means is that any claim with a date of service on or after October 1st must use the new ICD-10 code set.
For nurses, this will be on your patient’s 485 Service Authorization Form beginning October 1st. For personal care aides, if you do not have access to the 485, you may either contact your patient’s Case Manager or the Nurse in charge of your patient’s case for the appropriate codes.
RhinoBill also has a handy dandy converter that you can use to convert your ICD-9 code to it’s ICD-10 equivalent.
While a Google search of ICD-10 will bring up massive amounts of information...just check out these three sources and you will have all you need to know:
To set up your weekly e-mail reminder you must be logged into your user account. Once logged in, click on the "Account" icon then, click on "Reminders". Select the day of the week you would like to receive your weekly reminder and press "Save." You will receive an email on the day that you requested every week reminding you to put in your billing.
To cancel your weekly e-mail reminder you must be logged into your user account. Once logged in, click on the "Account" icon then, click on "Reminders". Select "No thanks, I don’t need a reminder" and press "Save." You will no longer receive email reminders to do your billing.
After your free trial month is over, you will be charged on the first of every month for the previous month. If you do not put in any claims in a month you will not be billed.
If there is a balance due on your account, it will be withdrawn from your (Visa or MasterCard) credit card, debit card, pre-paid credit card or checking account automatically on the first of the month.
Before your trial month is over you will be required to enter either your checking or card information so that your automatic payments can be processed. If you need to change your payment method or billing information, you can do so by logging into your account, clicking on the "Account" icon and then clicking the "Billing Info" menu item.
Here at RhinoBill we strive to create the fastest, easiest, most convenient billing system around. If you owe us a payment then your account is locked and you can’t access all of our great features until you pay your bill. If you had to wait for your check to arrive in the mail you could be waiting to bill for days! With our convenient on-line payment system if your card declines on the first of the month you simply have to log in to your account, press the "Pay Now" button and once your card is approved your account is unlocked instantly!
If you do not submit any claims in a particular calendar month, you will not be charged on the first of the next month. Charges are based upon the date the claim was created not the dates of service on the claim.
If you fix/adjust a claim this is sending a new claim to the state. You will be charged.
When you receive free refer-a-friend months, the free months will automatically be credited to your account for the following full calendar month. If you signed up for RhinoBill after the first day of the billing cycle, you will be charged a prorated amount for the partial month of service that occurred after your free trial month ended and then your next full month will be on us. We want you to get your money’s worth!
If you believe your account was charged in error, please contact call or e-mail us.
To change your payment information you must be logged into your account. Once you are logged into your account go to the "Account" icon and then "Billing Info."
Updating your address in your the 'Provider Info' section does not update your Billing address or vice versa.
Your bank statement is showing when they finalized the payment not when we sent the payment. We charge all accounts with balances on the 1st of each month. Banking processing times do vary, if the first falls on a Saturday, Sunday or holiday this can add additional time for your bank to process the payment. If you are paying by a check this will take longer than paying with a credit card.
With most holidays ODM will continue to pay claims on Thursday, but sometimes there may be a delay depending on when the holiday occurs. These delays are scheduled however so RhinoBill will notify you the week before the holiday of any impending paycheck delay.
Independent Providers: Once you are logged in, click on the "Create a Claim" button on the Dashboard. Select a Patient, Procedure Code, and Payer from the drop down lists. Next, enter the information for each visit that you wish to bill for. Once you are done inputting your visit information click on the "Continue to Preview" button. You will then have the opportunity to review the information in the claim before submitting it. Once you are satisfied that all of your claim information is correct click on "Save & Get Confirmation." You will receive a claim id for easy claim tracking and we will automatically send your claim according to the claim submission schedule. To view your claim or edit it before we send it off, simply go back to your Dashboard.
You may also quickly create a claim using the ClaimRecycle™ feature. For more detailed instructions please refer to the What is ClaimRecycle™ and how do I use it? Section.
Agency Billers: Once you are logged in, simply click on the "Create a Claim" button. There you can create claims using our pre-planed options or you can choose to customize your experience to however you prefer to enter your claims from our advanced options. Then, just begin typing in the last name of a patient in the provided field and the patient’s names that begin with the same letters you have typed will dynamically appear in a drop down list. Once you’ve selected the patient, choose a billing code and payer from the dropdown list, and then enter claim lines. After entering the claim information, you can click the "Continue to Preview Screen", if you did not turn off that feature, then either click "Save This Claim and Exit" Or "Save This Claim and Add Another." The entire claim entry process is designed to minimize keystrokes and the need to take your hands off the keyboard.
You may also quickly create a claim using the ClaimRecycle™ feature. For more detailed instructions please refer to the What is ClaimRecycle™ and how do I use it? Section.
ClaimRecycle™ allows you to quickly generate a new claim from an old claim by quickly changing the dates. If you work similar hours from week to week, you can make a new claim simply by moving all the dates from your previous claim forward by a week or a day.
To use ClaimRecycle™ you must be logged into your user account. Once logged in, find any claim that you would like to Recycle from your Claims tab and in the actions column, click the "ClaimRecycle™" link. This will take you to the Claim Entry screen with your service lines already filled in. All you have to do is move the days forward or backward by a day or week, and click on the "Continue to Preview Screen" button, and then on "Save & Get Confirmation." It’s as simple as that, claim submission in under 30 seconds!
If your claim has a status of "Received By RhinoBill" then you can still cancel it if you need to. Once logged in, from the Dashboard open the claims list under your top paycheck. In the actions column, click the Cancel link on the desired claim you wish to cancel.
If you claim has already gone to the state then it is too late to cancel your claim and you will have to wait until your claim pays out to make any adjustments to it.
The fix button allows you to submit an electronic claim adjustment to ODM, it does not mean that you have to fix your claim. When you need to adjust your claim for whatever reason you simply hit "Fix," change only what needs to be changed, Continue to Preview and then click Save & Get Confirmation.
A new claim will be sent to replace the originial claim. The state will look at the adjustment and the original and only pay or deduct the necessary amount on your next expected pay date. You can see exactly what adjustments were made and how much money will be paid or deducted from your next paycheck by clicking the Details button on your adjustment or original claim.
The fix option is only available when the claim has finished the claim cycle process. When your claim says ‘Paid in Full’ then you are able to ‘Fix’ it!
Be Advised: If you remove a visit from an adjustment claim ODM will take back the money from that visit.
In the Unresolved section of your Claims page, you can see how many Rejected or Paid Partial claims are waiting to be attended to. To adjust any of these claims, simply click "Fix." If the issue has been already been addressed in another claim or doesn’t need to be addressed at all, then simply click "Resolve". This will remove the claim from the Unresolved list, though please note that it will not make any sort of adjustment with the state.
When you press the void button you are sending an adjustment to ODM telling them to take back all of the money from that claim. This will create an adjustment on the top or your claims list. This does not work like a normal claim so don’t be alarmed that the amount is for the whole claim and not just your adjustment amount. The state will look at the adjustment and the original and deduct the entire amount on your expected pay date. You can see exactly what adjustments were made and how much money will be paid or deducted from your next paycheck by clicking the Details button on your adjustment or original claim.
The status of your claim lets you know where the claim is during the claim cycle process from creation to final payment. In RhinoBill your claim can have the following statuses:
Draft: A claim that has been created but saved to submit at a later time. This is a good option to use if you know you will be working another shift. Or if you are waiting for timesheets from other providers. When you are ready to send select ‘Edit’ and save.
Rec’d by RB: this stands for ‘Received by RhinoBill’. Your claim has been given a claim ID and will be sent to the appropriate payer when we send claims for the day. In this status you can ‘Edit’ a claim or cancel a claim.
Be Advised: If you cancel a claim, this deletes the claim from our system. Canceled claims are not sent!
Sent to Payer: The claim has been sent to the appropriate payer.
Accepted by Payer: The claim has been accepted by the appropriate payer. At this point they are deciding if the claim is eligible for payment. Accepted by Payer does not mean that the claim will pay, only that the payer received the claim.
Paid in Full: YAY!!! You got paid
Paid Partial: For some reason you weren’t paid the full amount you requested for reimbursement. At this point click ‘Details’ to see the specific reasons why your claim did not reimburse you fully.
Note: Your claim status will only change to "Paid Full", "Paid Partial", or "Rejected" if we are listed as your Trading Partner/Billing Agent with the repsective payer.
If your claim is Paid Partial or Rejected press the "Details" link on your claim to find out why. In the very right hand column there will be remarks codes to tell you why your claim was rejected. If you need help understanding these codes then call or e-mail us.
If you used to claim for a patient who is no longer on your Active Patients list then you have deactivated them. In order to bill for them again you will need to reactivate them. Simply go to the Patients tab and click on the "Inactive Patients" menu item. There you will find all of your old patient’s information. Now click on the “Edit” link and change the status to Active. Once you have saved the changes you will see the patient listed under Active Patients and will be able to bill for them again.
If you void a claim you are requesting that the entire amount on the claim is sent back. The total amount paid to you will be deducted from your next paycheck.
An adjustment is where you are correcting an issue with the original claim. Such as forgetting to add a shift, or billed for the wrong date on a claim.
For Independant Providers there are two overtime modifiers that you will use.
If your entire shift is overtime you will select the TU modifier when you create the claim.
If your shift started as regular time then went into overtime you will bill the overtime part of your shift using the UA modifier.
You are an independent contractor through the Ohio Department of Medicaid. The payer you send your claims to for reimbursement is who pays you.They will mail your check or you will receive your direct deposit from them.
Each payer has different expected pay dates. All claims sent to ODM by their cut-off time will be paid by ODM on Thursday the following week. Keep in mind, if there is a holiday that falls on a Monday that week your pay will be delayed until Friday. We will notify you any time there is a possible pay delay. If you are sending claims to a Managed Care Payer they do not give a specific expected pay date. Managed Care Payers are only required by law to determine payment within 30 days usually you will receive payment 30 days from when the claim was accepted by them.
When you are logged into your RhinoBill Account, click on the Help button and then on the link that says “ODM Direct Deposit Form.” Print and fill out this form, attach it to a voided check or deposit slip, and mail it to ODM. If you are changing your direct deposit then you can fax this form to ODM.
*Please note that your first 2-3 checks from ODM will come in the mail regardless of when you sent in your direct deposit form. For Managed Care Payers contact them directly to get set-up with Direct Deposit.
If you choose not to have direct deposit, your checks will be mailed to the address that ODM has on file for you on your expected pay date.
In order for someone to take taxes out of your paycheck, you have to be an employee of that organization. You are not an employee of ODM, you are an independent contractor through ODM.
Set Money aside
There are many websites out there that will calculate how much you should be withholding from your paycheck to cover the necessary federal and state taxes. If you do a search on the internet you will find several. Here are a few that you can use: http://www.paycheckcity.com/;http://www.payroll-taxes.com/calculators.htm; https://www.paycycle.com/external/business/paycheckCalculators.jsp; plus many more. RhinoBill is not affiliated with any of these companies; these are just examples of possible paycheck calculators that we have found on the internet. We do not endorse these companies nor do we denounce others.
Pay quarterly taxes to avoid a large payment once a year
If you go into an accountant every month or quarter they will calculate how much you are supposed to pay in taxes for that period of time and will assist you with paying your taxes. They will charge a fee for this service.
ODM will mail out your 1099 end of year statement by January 30th. They will mail the form to the address that they have on file so be sure that your address is current. You may also log in to ODM’ web portal (MITS) and pull your 1099 from there.
If you do not get your 1099 in February you will need to call ODM at 800-686-1516.
We use Secure Socket Layer (SSL) for secure transmission whenever we ask for or display information about your account. SSL applies encryption between two communicating applications, such as your PC and our corporate internet server. When your data is transmitted over the internet, it is encrypted or "scrambled" at the sending end and then decrypted or "unscrambled" at the receiving end. We use 128-bit encryption, because that’s the highest level of security available today.
Additionally, our site requires that you choose a unique User ID and Password. Thereafter, each time you sign on, your identity is confirmed by a series of authenticating steps. After authentication, we use a "cookie" to identify you throughout your session.
RhinoBill is HIPAA compliant. RhinoBill is up-to date with our HIPAA Policies and Procedures. Additionally, you are required to agree to our "HIPAA Business Associate Agreement" which outlines our obligation to protect Private Health Information. You can read or print this agreement at any time by clicking on the link "HIPAA Agreement" from our homepage.
For Independent Providers earning free months of service with RhinoBill is easy! For each new member you refer to RhinoBill you will receive a free month of billing. Once someone enters your Username when they sign up, you will automatically receive a free month. What’s more, there’s no limit to the number of free months you can accumulate if you sign up more members! Agencies are not eligible for referral free months.
When you sign up for RhinoBill, your 835 form will be sent to ODM. This authorizes ODM to send back your claim information, so that we can display the status of your claims on the My Claims page.
It’s all about convenience and better customer service!
The 835 form gives you the freedom to take control of your claims without having to wait on hold at the state for hours. When a claim is Paid Partial or Rejected, you will immediately know why it was not paid in full and you can make adjustments instantly. It also allows you to receive a better quality of customer service from us. There is no more theorizing about why your claim could have been rejected, as the information is right there!
This also allows you to do claim adjustments right from your RhinoBill account. All you have to do is press the Fix button, make any necessary changes and press save.
The 835 also enables us to offer you income verification reports, as we’ll now be able to knowledgeably vouch for your income. No more trying to pry the information out of the state.
MITS is Ohio’s Medicaid Information Technology System. It is both the system that validates your claims and a website where you can access your Medicaid information.
If you encounter an issue with your claims that needs further investigation or need us to do a complicated claim adjustment, we will need access to your MITS account to help you further. In the MITS system, you can also look up your 1099 information, retrieve your remittance advice, and apply for prior authorization among other things.
Don’t have time to complete a MITS account? No worries, we’ll take care of it for you! All you have to do is give us a call and let us know, we’ll take care of the rest.
To sign up for a MITS account go to: https://portal.ohmits.com/Public/Providers/Account%20Setup/tabId/49/Default.aspx
MyCare Ohio is a demonstration project that integrates Medicare and Medicaid services into one program, operated by a Managed Care Plan.
A contract with the Plan is not required during the Transition period, However, existing providers must make authorization and payment arrangements directly with the MyCare Ohio Plan.
All Conditions of Participation and Service Specifications set forth by ODM will remain in effect and PCG will continue to provide the compliance oversight of these providers.
Click here **VIDEO** to see how to get everything setup for submitting your MyCare Claims. Or you can read/follow these simple steps:
*If you need to change for an existing patient Select ‘Details’ beside the patients name you wish to update. Click ‘Edit’ next to the Claim Preferences Section. Select the new payer.
Ohio Medicaid contracts with Managed Care Plans (MCPs) to provide quality healthcare to many Ohio Medicaid consumers. Like HMOs, these companies agree to provide Medicaid benefits to people in exchange for a monthly payment from the state. This results in a state run benefits program with the quality control standards of a private health insurance company.
Ohio’s Medicaid Managed Care Program covers primary and acute care services mandated by the federal government as well as optional services Ohio has elected to provide. Some services are limited by the number of visits per year or the setting in which they can be provided.
Managed Care currently only accepts agency providers. If you are an agency provider and would like to enroll as a Manager Care Provider you must contact the MCP that you wish to contract with.
Provider Services (833) 644-6001
Monday-Friday 8am-6pm EST
Provider Manual
Website
Provider Services (800) 331-1476
Monday-Friday 8am-5pm EST
Provider Manual
Website
Provider Services (866) 246-4358
Monday-Friday 8am-8pm EST
Provider Manual
Website
Provider Services (800) 488-0134
Monday-Friday 8am-6pm EST
Provider Manual
Website
Provider Services (800) 626-2741
Monday-Friday 8am-5pm EST
Provider Manual
Website
Provider Services (855) 322-4079
Monday-Friday 8am-5pm EST
Provider Manual
Website
Provider Services (419) 887-2535 or (800) 891-2542
Monday-Friday 8am-5pm EST
Provider Manual
Website
Provider Services (877) 842-3210
Monday-Friday 8am-5pm EST
Provider Manual
Website
Phone: 800-686-1516
Website: http://www.medicaid.ohio.gov/PROVIDERS.aspx
Phone: 800-617-6733
Email: dodd.support@dodd.ohio.gov
Website: http://dodd.ohio.gov/medicaid/Pages/default.aspx
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Phone: 614-441-4211
E-Mail: support@rhinobill.com
Log into your RhinoBill account
Click on your “Payers” tab at the top of your screen
Click “Add” a payer
Click on “DODD”
Select “Department of Developmental Disabilities” from the drop down
Add your 7 digit DODD CONTRACT number to the “Payer Provider ID” box (This is not your medicaid id).
Add your contract “Begin date and End date” (you can select the date as to when your patient switched)
Select the “Procedure Codes” that you will be billing for your patient
Click “Save”
Click on your “Patients” tab at the top of your screen
Click “Details” next to your patient’s name
Click Edit next to Claim Preferences
Click on “Department of Developmental Disabilities” and add your patients 12 digit Medicaid ID number
Select the “Procedure Codes” and “modifiers” that you will be billing according to your all service plan
Click “Save”
You are now ready to create your first claim. Creat your claim as normal, but with selecting DODD as the payer.
Pay is still handled by shared services for the state of Ohio.
If you have not set up direct deposit for the DODD a check will be mailed to you.
If you would like to set up direct deposit, please follow the steps below.
At the top right of this help section under Forms you May Need the direct deposit form is the first one.
Fill out all your personal information at the top
Type of transaction will be ADD
Choose state agency will be DODD
You will not fill out the provider and NPI number or assigning Authority for DODD leave that section blank.
Follow the instructions at the bottom of the page to submit it via Email, Fax, or Mail.
Make sure to include a copy of a voided check or bank letter with account information or it will not be processed.
Follow the instructions at the bottom of the page to submit the form.
Once you set up DODD as a payer, we generate a contract thats automatically sent to the DODD. This contract can take up to a week to be processed by the state. This will cause a delay in your first payment by a week.
The cutoff for DODD claims is Wednesday at 11am. Claims submitted before the deadline will be processed and paid on Thursday two weeks later. If you are not signed up for direct deposit your check will be mailed on Thursday and will take additional time to reach you.
DODD does not require you to bill multiple shifts for the same patient on the same day separately.
Instead you will total all your hours for the day up and submit one claim with the total hours worked.
If you worked two 8hr shifts on 6/1 for John Smith your billing would be one 16hr shift on 6/1 for DODD.
Click create a claim
Select Department of Developmental Disabilities from the payer drop down.
Select the patient you are going to be billing for
Select the procedure code you are billing
Select the staff – This will always be 1 unless you have another provider working with you at the same time for the same code.
Select the number of individuals – This will always be 1 unless you are doing a group visit
Then enter the dates you worked and how many hours or units you worked.
No additional modifiers are required unless you are providing the additional Medical Assistance (MaM) or Behavioral Assistance (BaM).
Currently, the Base Rate calculation is straightforward: the first four units, equivalent to 60 minutes, of any visit are paid equally. Whether you bill 1 unit or 4 units, the pay remains the same. However, the new method introduces complexity. Don't worry, we'll handle the billing adjustments, but you may notice a pay change for shorter visits.
Here's how it works: