Provider News

Provider Revalidation: Just like the Holidays, Wave 2 is sneaking up on us fast!

Be on the lookout for Revalidation Mailings Mid Fall. This will include both provider and portal application access information.

Here are a few tips to prepare:

A provider will have 35 days to complete their revalidation from the date of the letter.

Make sure to have an updated W9 ready for upload.

Be prepared for those disclosure questions, which can be reviewed here:
Enrollment Disclosures (ri.gov)

We have a handy Provider Enrollment User Guide located here – https://eohhs.ri.gov/sites/g/files/xkgbur226/files/2021-03/provider_revalidation.pdf  to help answer pre-revalidation questions.

We also have a new FAQ located HERE - Revalidation FAQ Sheet.docx (live.com)

Providers Required to Revalidate:

Physician

Psychologist

Billing - Nurse Practitioners

Home Stabilization

Centers of Excellence

Peer Recovery Services

Emergency Behavioral Health Services

Physical Therapists

If you have questions, please contact the Customer Service Help Desk at 401-784-8100 or 800-964-6211 for instate toll calls.

 

Attention Hospice Providers

EOHHS has implemented a rate increase for five hospice procedure codes that are effective for dates of service as of 10/01/2022.  This is to comply with the new federal minimum rates.  The below procedure codes reflect this most recent update.  Please begin billing at the new rates in order to be reimbursed at these higher rates for dates of service 10/01/2022 forward. 

Description

Procedure Code

Effective 07/01/2022

Effective 10/01/22

Hospice Continuous Home Care Per Hour

T2043

$63.67

$64.83

Hospice Inpatient Respite Per Diem

T2044

$518.96

$527.20

Hospice General Inpatient Care Per Diem

T2045

$1,112.44

$1,131.29

Services of clinical social worker in hospice setting

G0155

$15.67

$16.21

Direct skilled nursing services of a registered nurse in a hospice setting

G0299

$15.67

$16.21

 

LTSS Providers

Effective 9/13/22 you will notice that two of the waiver/program names have changed in the Healthcare Portal when you are checking for member eligibility.  The member is still eligible for the same services that they were eligible for under their prior waiver/program name.  Please note that only the names of the programs have changed.   

Core Community Services  has changed to “LTSS – HCBS Services”

DEA Community Services has changed to “OHA Community Services”

 

Additionally, recipients can now simultaneously be enrolled in the LTSS-HCBS (formerly core) and one of the following waiver programs:

OHA community waiver program

Shared Living

Habilitation Community Service

Habilitation Group Home Service

 

 

 

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