The Maryland Medical Assistance Provider Handbook

The Maryland medical assistance Provider Handbook is a great resource for providers who want to learn more about the program and how it can benefit their patients.

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Introduction to the Maryland Medical Assistance Provider Handbook

The Maryland Medical Assistance Provider Handbook is a comprehensive guide for providers who participate in the Maryland Medical assistance (MA) Program. The handbook covers all aspects of the MA program, from provider enrollment to billing and claims processing. The handbook also includes detailed information on provider eligibility requirements, covered services, and reimbursement rates.

Eligibility requirements for Medical Assistance in Maryland

In order to be eligible for Medical Assistance in Maryland, an individual must meet certain financial and non-financial requirements.

Financial requirements:
In order to meet the financial requirements for medical assistance in Maryland, an individual must have a countable income that is below a certain level. For most individuals, this income level is 138% of the federal poverty level (FPL). However, there are some exceptions to this rule. For example, pregnant women and children under the age of 19 may be eligible for medical assistance if their countable income is below 233% of the FPL.

Non-financial requirements:
In addition to meeting the financial requirements discussed above, an individual must also meet certain non-financial requirements in order to be eligible for medical assistance in Maryland. These non-financial requirements include being a U.S. citizen or legal immigrant, and being a resident of the state of Maryland.

How to apply for medical assistance in Maryland

Applying for medical assistance in Maryland is a two-step process. Eligible individuals must first complete an application and then submit it to the Maryland Department of Health and Mental Hygiene (DHMH).

To complete an application, individuals must provide their name, Social Security number, address, and financial information. They will also need to list any other health insurance coverage they have. Once the application is completed, DHMH will use the information provided to determine eligibility for medical assistance.

If an individual is found to be eligible, they will be issued a Maryland Medical Assistance card. This card can be used to receive discounts on medical services at participating providers. To find a list of participating providers, individuals can visit the DHMH website or contact their local county office.

What services are covered by medical assistance in Maryland?

In general, medical assistance in Maryland covers a wide range of medical and health services. These services include, but are not limited to:

-Inpatient and outpatient hospital care
-Physician services
-Prescription drugs
-Laboratory and X-ray services
-Transportation to medical appointments
-Physical, occupational, and speech therapy
-Home health care

How to bill for medical assistance services in Maryland

In order to receive reimbursement for medical assistance services provided in Maryland, providers must follow the billing guidelines set forth by the state. This handbook will provide you with all the information you need to properly bill for services rendered.

When billing for medical assistance services, please include the following information:

– The date of service
– The provider’s name and Maryland license number
– The patient’s name and date of birth
– The procedure code(s) for the service(s) performed
– The diagnosis code(s) for the service(s) performed
– The amount charged for each service
– The signature of the provider or authorized representative

How to get paid for medical assistance services in Maryland

In order to get paid for providing medical assistance services in Maryland, you must follow the requirements in this handbook. These requirements are designed to ensure that medical assistance services are provided in a way that is consistent with the Medicaid program’s goals and objectives.

In order to get paid, you must:

– Be enrolled in the Maryland Medical Assistance Provider Handbook.
– Be licensed in good standing by the state in which you practice, if applicable.
– Meet all applicable federal and state laws and regulations.
– Comply with all terms and conditions of your provider agreement.
– Submit claims for payment using an approved claim form and within the required timeframe.
– Keep accurate and complete records of all medical assistance services provided, as well as any other documents required by the Handbook.

How to appeal a medical assistance decision in Maryland

If you disagree with a decision made by the Maryland Medical Assistance program, you have the right to file an appeal. The first step is to contact your case worker and explain why you believe the decision is incorrect. If you are not satisfied with their response, you can request a fair hearing.

To request a fair hearing, you must submit a written request within 90 days of the date of the notice of the action that you are appealing. Your request must include your name, address, and telephone number; the reason for your appeal; and any other relevant information. You can submit your request by mail or fax to:

Office of Hearing and Appeals
Dept. of Health & Mental Hygiene
201 W. Preston St., Suite 1113
Baltimore, MD 21201-2399
Fax: (410) 767-5689

A fair hearing will be scheduled within 30 days of receiving your request, and you will be notified of the date, time, and location of the hearing. At the hearing, you will have an opportunity to present your case before an impartial hearing officer. The hearing officer will issue a decision within 10 days of the hearing.

Frequently asked questions about medical assistance in Maryland

1. What is medical assistance?
2. How do I apply for medical assistance?
3. How do I know if I am eligible for medical assistance?
4. What are the income guidelines for medical assistance?
5. How often do I need to renew my medical assistance?
6. What are the different types of medical assistance?
7. What services does medical assistance cover?
8. Does medical assistance cover dental services?
9. How can I find a provider who accepts medical assistance?
10. I am a provider – how do I become a participating provider in the Maryland Medical Assistance Program?

Resources for medical assistance providers in Maryland

The Maryland medical assistance provider handbook is a resource for medical assistance providers in Maryland. The handbook includes information on how to access medical assistance services, how to use medical assistance benefits, and how to appeal denials of medical assistance benefits.

Contact information for medical assistance in Maryland

If you are a medical provider in Maryland and you need to contact the Maryland Medical Assistance program, you can find the relevant information below.

For general inquiries, you can call 1-800-336-6207. For questions about provider enrollment, you can call 410-767-5370. If you need to contact the office of managed care, you can call 410-387-0523. Finally, for questions about provider manuals or policy updates, you can call 410-767-5357.