Read the instructions carefully as there are specific procedures and protocols DDA and DHCF has implemented to address these areas of concern. Download this as a PDF document, if desired.
If the services identified in the Service Authorization (SA) letter from DDS are incorrect, please send an email to the following persons:
- Service Coordinator
- Service Coordinator Supervisor
- Supervisor Waiver Specialist that approved service
- Waiver Unit Supervisor
Providers must pay close attention to this as when the information gets sent to Delmarva the PA will be incorrect. Remember Garbage In, Garbage Out! Service Coordinators cannot assist providers with billing or PA issues. They can only provide assistance with service requests.
Prior to billing Everything Must Match! The Service Authorization from DDS must match the Remittance letter from ACS (PA letter). If the information does not match DON’T BILL. Providers must send the copy of the Service Authorization and the PA letter and identify what is the discrepancy.
- SA letter states Supported Living (Moderate) T2016 U4
- PA letter stated Supported Living (Basic) T2016 U8
Note: When you receive the SA letter from DDS make sure it is correct; if it not correct it will post incorrectly in MMIS. If you bill off incorrect info, you must do a billing adjustment.
If there is discrepancy between the SA letter and the PA letter, please send email to the following persons:
Service Coordinators cannot assist providers with billing or PA issues. They can only provide assistance with service requests.
Providers must send the following information when making inquiries regarding discrepancies:
- Name of Individual
- Name of Service Procedure Code/Modifier
- Date Range of the Service
- Action Date (Date that service was authorized by waiver unit)
- PA #
- Reason for denials
- TCN # (only applies if you have already billed for the service).