Effective 10-1-21: Medicaid Claims will Deny if Referring, Ordering, Prescribing, and Attending Providers are Not Enrolled
Effective October 1, 2021, Florida Medicaid Claims will Deny if Referring, Ordering, Prescribing, and Attending Providers (ROPA) are Not Enrolled.
The ROPA does NOT have to be Medicaid participating, only enrolled as a ROPA.
Link to: Frequently Asked Questions
FLORIDA MEDICAID
A Division of the Agency for Health Care Administration
Florida Medicaid Health Care Alert
Provider Type(s): All
Effective 10-1-21: Claims will Deny if Referring, Ordering, Prescribing, and Attending Providers are Not Enrolled
Effective October 1, 2021, any fee-for-service (FFS) claim submitted with a National Provider Identifier (NPI) for a provider not enrolled with Florida Medicaid will deny, and the provider will not receive reimbursement for services. This includes claims that list a Referring, Ordering, Prescribing, or Attending (ROPA) provider. ROPA providers must be enrolled with Florida Medicaid in accordance with Title 42, Code of Federal Regulations, Section 455.410(b).
Starting October 1, 2021, claims will not pay for any practitioner, group practice, facility, or pharmacy providing services to Florida Medicaid recipients based on a ROPA provider’s referral, order, prescription, or attending services, unless the ROPA provider identified by NPI on the FFS claim is actively enrolled with Florida Medicaid.
Florida Medicaid features a quick and easy, automated ROPA provider enrollment application on the Florida Medicaid Web Portal Enrollment Application Wizard page.
Link to: Complete Article
Link to: Enrollment Application Wizard
ERRORS IN 2021. You will receive a downloadable notebook (PDF)… packed full of
information for YOUR specialty… that you will use all year! Due to COVID-19 this
year’s classes will be held via webinar, at this time we will not be offering in person
sessions for 2021.
Highlights: Medicare Updates 2021, New E&M Office Visits, ICD-10 Updates, CPT and
ICD Relationships, tips to dispute third party payer refund requests, does it need a
modifier? Bundled or not bundled, Missed coding opportunities, the “Queen Bee’s
famous coding combinations, Are you billing for EVERYTHING you do?
Visit the link below to sign up and check out our upcoming seminars:
https://medicarecoding.com/annual-seminar/
Lorraine Molinari
Queen Bee of Medicare
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