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| Macsis Support - Phone 1-877-462-2747 |
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| Behavioral Module |
| MAC-Search |
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| Claims and Related Documents (Top of Page) |
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| APUPD Process |
| APUPD Weekly Schedules and Status |
| BENEF Explanation (Sample) |
| Board Operations Manual - Claims Section |
| BRULE Explanation |
| BRULE Explanation (Sample) |
Caution/Outlier/Notify Reports Documentation
 • HIPAA Notify Program |
| Cheat Sheets and FAQ's |
| Claims and Payment Training [PDF] [PPT] |
| Claims Billing, Weekly Schedules and Status |
| Claims Contacts - ( by Name ) (by County) |
| Claims EDI File Processing for the 837P in MHHIPAA |
| Claims Extract Layout |
| Claims Post Report Layout (102 ASCII File) |
| Codes |
| Contracts, Pricing & Adjudication Training [PDF] [PPT] |
| Contract, PSCHD & Procedure Code Tables |
| Denying Claims Beyond Submission Deadline, Procedure for |
| Fixing Retroactive Medicaid-Eligible Claims |
| FY Claims Data For Testing [Excel] [ PDF] |
HIPAA Service Rate Form (Tier 2)
• ODADAS Service Codes [Excel] [PDF]
• ODMH Service Codes [Excel] [PDF]
•HIPAA Service Rate Form (Tier 2) Instructions |
| MACSIS HIPAA Claim Correction Policy |
| MACSIS HIPAA Claim Correction Procedure |
MACSIS HIPAA Claim Correction Form [PDF] [Word]
• Instructions for Completing MACSIS HIPAA Claims Correction Form |
MACSIS Testing Information
• MACSIS HIPAA EDI Claims Testing & Approval Policy
• Submit Test MACSIS EDI Claim File for Approval Procedure
• MACSIS EDI Claims Testing Request Form [Word] [PDF]
• NPI Claims EDI Checklist |
| MACSIS Performance Overview - By Boards Documentation |
MACSIS Technical Informational Guides
• 837 Professional Claim v4010 - NPI Format
- Sample 837 NPI Format
• 835 Health Care Claim Payment Advice - NPI Format
- Sample 835 NPI File |
Member/Claims Transfer, Instructions for Completing
• Member/Claims Transfer Request Form [PDF] [Word] |
| MH Same Day Service Reporting - Roll-Up Categories for Duplicate Checking |
| Naming Conventions |
| ODADAS Roll-Up Categories for Duplicate Checking |
| Overnight File Program |
| Provider (PROV) Information Listing |
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| Codes and Related Documents (Top of Page) |
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| Affiliation Codes |
| AOD HIPAA Modifier Code Table |
| AOD HIPAA Procedure Code Table |
| AOD Procedure Code, Modifier and Medical Definitions Matrix |
| BENEF Explanation (Sample) |
| BRULE Explanation |
| BRULE Explanation (Sample) |
| Contract, PSCHD & Procedure Code Tables |
| Diagnosis Codes - Valid BH ICD-9-CM Under HIPAA |
| Diamond PREDI Error Codes (HIPAA) |
| Diamond Reason Codes (HIPAA) |
| Medical Definitions for FY05 |
| MH HIPAA Modifier Code Table |
| MH HIPAA Procedure Code Table |
| MH Procedure Code Table Explanation |
| Naming Conventions |
| ODADAS Terms and Definitions |
| ODMH Procedure Code, Modifier and Medical Definitions Matrix |
| ODMH Residential Housing Service Categories |
| Place of Service Codes |
| Procedure Codes and Affiliated Price Schedules |
Remittance Code Sets :
• Crosswalks
-Diamond 8+ to HIPAA 835 Reason Codes
-Diamond 8+ to HIPAA 835 Default Reason Codes
-HIPAA 835 to Diamond 8+ Reason Codes (Reverse Crosswalk)
• HIPAA (835) Code Sets
-Claim Adjustment Group Codes
-Claim Adjustment Reason Codes
-Claim Filing Indicator
-Claim Status Code
-Health Care Remark Codes
• ODJFS
- ODJFS Errors Returned from Double-Loop
- MCP Enroll/Disenroll Codes
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| Service Population Codes |
| TASC Build Description |
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| Contacts (Top of Page) |
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| Claims Users' Group |
| Finance Team Members |
| Member Users' Group |
| MIS Team Members |
| Project/Operations (POP) Team |
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| Extracts and Related Information (Top of Page) |
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| Affiliation File Extract Layout |
Caution/Outlier/Notify Reports Documentation
• HIPAA Notify Program |
| Claims Extract Layout |
| Claims Post Report Layout (102 ASCII File) |
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| MACSIS Performance Overview - By Boards Documentation |
| MCP Extract Layout and Field Definitions |
| Member & Eligibility File Extracts & Subset Construction |
| New and Old Claims Extract Layout |
| New and Old Member Extract Layout |
| Provider/Vendor File Layout |
| Short Claims Extract Layout (Excel) (PDF) |
| Short Claims Extract Layout with Field Description |
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| FAQ's and Cheat Sheets (Top of Page) |
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| Claims: |
| APUPD Process |
| BRULE Explanation |
| Claims EDI File Processing for the 837P in MHHIPAA |
| Contracts and Pricing Flowchart |
| Contract, PSCHD & Procedure Code Tables |
| Correcting OHIO Claims - MBRIN |
| Correcting OHIO Claims - PRVIN |
| Denying a Claim |
| Denying Claims Beyond Submission Deadline, Procedure for |
| FAQ - Claims |
| Fixing Retroactive Medicaid-Eligible Claims |
| Life Cycle of a Claim Flowchart |
| Life Cycle of a Claim Documentation |
| Making a Denied Claim Payable |
| Putting a Claim on Hold |
| Reporting Third Party Insurance on the 837P |
| Reversing a Claim |
| Sample 835 v4010 UPI File |
| Sample 835 v4010 NPI File |
| Sample 837P v4010 UPI File |
| Sample 837P v4010 NPI File |
| Splitting a Claim |
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| Un-Pending Claims |
| Member: |
| Completing the Member Screen |
| Enrolling a Client |
| FAQ - Electronic Eligibility Inquiry |
| FAQ - Member |
| FAQ - Member & Medicaid Eligibility FAQ |
| Residency Determination Cheat Sheet |
| Search for a Member |
| Naming Conventions: |
| MACSIS Naming Conventions |
| Reports List: |
| List of all MACSIS Reports |
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| Forms (Top of Page) |
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| Account Request Form |
Claims Correction Form, MACSIS HIPAA (Draft) [PDF] [Word]
• Instructions for Completing MACSIS HIPAA Claims Correction Form |
| Disclosure of Information Form (Board Staff) |
HIPAA Service Rate Form (Tier 2) [May 7, 2003]
•ODADAS Service Codes[Excel] [PDF]
•ODMH Service Codes[Excel] [PDF]
•HIPAA Service Rate Form (Tier 2) Instructions |
| MACSIS EDI Claims Testing Request Form [PDF] [Word] |
Member/Claims Transfer, Instructions for Completing
• Member/Claims Transfer Request Form [PDF] [Word] |
Member Enrollment Form
• Member Enrollment Form - Instructions for Completion |
| Provider Request Modification Form [Word] [PDF] |
| Report Request Form |
| Request to Remove Client From MACSIS (Form) |
| Residency Dispute Determination Form - ADM038 |
| Residency Verification Form |
| TCP/IP Access Request Form (Unix Accounts) |
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| MACSIS Manuals (Top of Page) |
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| Board Operations Manual - Claims Section |
| Board Operations Manual - Member Section |
Diamond 725 Documentation |
HSD's Documentation, mostly in individual Word .doc files, is available by FTP qualifying
Boards/Consortium entities. Note these are copyright materials and are considered "trade secrets". FTP
access to obtain these can be arranged through Jp. Martin or Kendall Fells.
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| Guidelines Pertaining to the Implementation of MACSIS under HIPAA |
| Guidelines & Operating Principles for Residency Determination Among CMH/ADAS/ADAMHS Boards |
| Project Technical Documentation |
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| Meetings & Minutes (Top of Page) |
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| Behavioral Module Meeting Minutes |
| Pop Meeting Minutes |
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| Member Related Information and Documents (Top of Page) |
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| Affiliation Codes Explanation |
| Affiliation File Extract Layout |
| Board Operations Manual - Member Section |
| Cheat Sheets and FAQ's |
| Enrollment Contacts - (by Name) (by County) |
Member Enrollment Form
• Member Enrollment Form - Instructions for Completion |
| Enrollment Procedures, MACSIS Support Desk |
| Guidelines Pertaining to the Implementation of MACSIS under HIPAA |
Member/Claims Transfer Request Form [PDF] [Word]
• Member/Claims Transfer, Instructions for Completing |
| Member & Medicaid Eligibility FAQ |
| Member Error Reports |
| Member FAQ |
| Member Training [PDF] [PPT] |
| New and Old Member Extract Layout |
Removal of Client Data from MACSIS
• Request to Remove Client from MACSIS Form |
Residency:
• Dispute Determination Process Instructions for Executive Directors
• Guidelines & Operating Principles for Residency Determination among CMH/ADAS/ADAMHS Boards
• Out-of-County Enrollment Process
• Residency Verification Form |
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| Payment Related Documents (Top of Page) |
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| APUPD, Check Post, Claims Reports |
| Diamond Reason Codes |
| Double Loop Diagram |
| Finance Guidelines |
| Production Schedule |
Remittance Information:
• Code Sets
• Electronic Remittance Advice (ERA)
• Paper Remittance Reports
• MACSIS 835 Health Care Claim/Payment Advice Companion Guides |
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| Policies & Guidelines (Top of Page) |
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| Change Control Policy |
| Guidelines Pertaining to the Implementation of MACSIS under HIPAA |
Removal of Client Data from MACSIS
• Request to Remove Client from MACSIS Form |
| Finance Guidelines |
| Board Operations Manual - HIPAA Claims Section |
| Board Operations Manual - HIPAA Member Section |
MACSIS Board-State BAA/TPA
•Addendum to TPA |
Residency:
• Dispute Determination Process Instructions for Executive Directors
• Enrollment Procedures - MACSIS Support Desk
• Guidelines & Operating Principles for Residency Determination among CMH/ADAS/ADAMHS Boards
– Appendix A - Guidelines used in Determining County of Residence for College Students
– Criminal Justice System and Residence Determinations
• Out-of-County Enrollment Process
• Out-of-County Enrollment Letter
• Out-of-County Enrollment Summary Matrix
• Residency Dispute Determination (RDD) Process
• Residency Dispute Determination (RDD) Request Form
• Residency Verification Form |
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| Production Schedules (Top of Page) |
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| MACSIS Production Schedule Information |
Schedule of Explanations:
• Schedule Basics
• MACSIS Schedule Definitions and Regular Run Times
• Board Claim Edit Groups |
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| Reports (Top of Page) |
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| Technical Documents (Top of Page) |
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| Account/Login Form |
| Account Request Form - UNIX OSG-DAS TCP/IP Access Request |
| Account User Request Spreadsheet |
Caution/Outlier/Notify Documentation
• HIPAA Notify Program |
| Claims Post Report Layout (102 ASCII File) |
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| Determine Your IP |
| Disclosure of Information Form (Board Staff) |
| EOL Issues |
| Pricing for Boards (File Layout) |
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| FTP Accounts and Directories |
Top of Page