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Fact sheets
Quick reference guides for various ProviderOne processes and policy issues. Fact sheets assist you with common issues experienced with ProviderOne and Apple Health (Medicaid).
On this page
Do you have questions or need more information? Our customer service center is here to help!
Claim submission
- Balance billing prohibition
- Save and retrieve a claim (using DDE)
- Hospice providers: reporting nursing home NPI numbers on claims
- Creating templates and submitting a template claim
- How to make billing orthodontics easy
- How to read EOB codes
- How to bill with two authorization numbers
- Institutional type of bill codes for direct data entry (different than standard codes)
Client eligibility
- Successful eligibility checks using ProviderOne
- Client benefit limit inquiry (in ProviderOne)
- Provider spenddown step by step
Provider referrals
- Removing a provider's name from the list of providers accepting new patients
- FAQ for local jails and prescriber enrollment requirements
- FAQ on the Medicaid requirements for ordering, prescribing, and referring providers
- Provider inquiry in ProviderOne
Billing with commercial insurance or Medicare as primary
- Reporting Medicare/Managed Medicare and commercial payer data on an 837 transaction
- Submitting professional crossover claims with secondary insurance
- DDE Medicare crossover claims for 5010
Taxonomy
Contact
Medical Assistance Customer Service Center (MACSC)
Online: secure form
Phone: 1-800-562-3022