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PROMISe Update #04-06
April 26, 2004

Use of practitioner’s license vs. MA Provider ID - Clarification
PCPA has received numerous calls and emails regarding the use of a practitioner’s license number vs. their Medical Assistance Identification (MA ID) number. The following information was included in PROMISe Update #04-04, however the Association has decided to reprint the information due to the numerous calls.

“PCPA is aware of the issues around using a practitioner’s MA ID number versus their license number. At this time, it appears that PROMISe will only accept the MA ID number. OMHSAS is looking into this issue and PCPA will report any changes to members immediately upon receipt of the information.”

Since PROMISe Update #04-04 PCPA has learned that BHRS providers may now use the practitioner’s license number ,however partial hospitalization and outpatient services are still required to use the MA ID number.

Educational Opportunities Available
The Department of Public Welfare (DPW) has developed a PROMISe e-Learning course, which is the first in a series of billing related courses. This course will focus on the CMS-1500 form and walks providers through how to complete a CMS-1500 paper claim form and provides demonstrations and examples of completed forms. The course is available on the PROMISe web site at http://promise.dpw.state.pa.us. The Office of Medical Assistance Programs (OMAP) is also considering offering a training for billing agents in May. PCPA will inform members as soon as more information is available.

Enrollment Concerns Remain
Some of PCPA’s members have expressed concern about the length of time it is taking for enrollments to be processed. OMAP recognizes that there is a backlog and has devoted additional staff to catch up. Any PCPA member who is unable to process claims because of these enrollment delays and who is concerned about the 180-day limit on when claims can be submitted is encouraged to complete a PROMISe Question Submission Form indicating this concern and forward it to PCPA (rebecca@paproviders.org or fax to 717-657-3552).

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