New requirements for ambulance provider claim submissions

HCA Apple Health

PROVIDER ALERT

Due to recent ProviderOne system updates, effective immediately, ambulance providers submitting a claim for a return trip must add a claim note to field 80 (Remarks) on the UB-04 claim form, or to field 19 on the CMS-1500 claim form. The claim note should read “Not a Duplicate.” 

Claims for return trips will automatically be denied if this note is not added.  

This update will be published in the July 2016 edition of the Ambulance & ITA Billing Guide. 

Questions can be directed to Shauna Penn, Ambulance & ITA Program Manager, (360) 725-1952 or Shauna.Penn@hca.wa.gov.