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Changes to KePRO Issued Service Authorizations

KePRO will handle Service authorizations created by KePRO that require changes. Change requests should be faxed to 1-800- 922-9847 with the following information:

1. Recipient name and MID #
2. Service authorization number. KePRO service authorizations will begin with the letter "P"
3. The change you are requesting, i.e. change in procedure code, dates of service, units etc
4. Indicate whether you want a confirmation that this change has been made and if so, include your fax number on the request. If another party also needs to know that this change has been made, please include that party's name and fax number


Posted: 7/26/2013

Announcements


Policy change that will impact Emergency Department claims

On March 1, 2012, NH Medicaid implemented a policy that imposed a 4-visit service limit on Medicaid recipients' visits to hospital emergency Departments. After analyzing that policy, NH Medicaid determined that it did not have the desired effect of redirecting patients to more appropriate sites for care. Therefore, NH Medicaid is removing this limit retroactively back to its effective date of March 1, 2012.

NH Medicaid recipients will receive notice of the change by the end of July. This will notify Medicaid recipients of the service limit change and that they may be entitled to receive reimbursement from a hospital if they made payments for an Emergency Department visit that was denied for being in excess of the 4-visit limit. A copy of the notice sent recipients will be available to you in the message center when it is mailed to the recipients.

To facilitate a smooth process for timely payments, NH Medicaid will issue specific instructions to the hospitals on July 29, 2013, for the submission of ED claims for this period. In addition to issuing instructions, Medicaid and The Health Enterprise Medicaid Management Information System (MMIS) will work with each hospital individually to process their claims submissions.

We look forward to working with you to continue to find ways to ensure that Medicaid enrollee's receive the best possible care in the most appropriate and cost effective settings.


Posted: 7/25/2013


KEPRO is URAC accredited in Health Utilization Management, Disease Management and Case Management. We are also licensed to perform medical reviews in 29 states.

Starting 10/18/2013, Atrezzo Connect is available for DME providers only at this time for case submission for NH Medicaid Authorizations. Other providers types will be available soon. LOG IN or REGISTER here...

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