RA Newsletter
New Mexico Medicaid
January 15, 2013
** NEW** New Mexico Medicaid New HIPAA
In This Issue
** NEW** New Mexico Medicaid New
HIPAA Electronic Transactions
** NEW** NCCI (National Corrective
Coding Initiative)
** NEW** Basic Billing Webcast
NM Medicaid EHR Incentive
Attention Anesthesia Services Providers
Electronic Transactions
As of January 1, 2013 New Mexico Medicaid supports electronic
eligibility and claim inquiry transactions that are fully 5010 and
HIPAA Operating Rule compliant.The 270/271 and 276/277
transactions offer more detailed information than was previously
available to New Mexico providers in a nationally accepted
electronic format. Providers are encouraged to take immediate
advantage of the new transactions.
The two new Companion Guides for the 270/271
(Eligibility/Response) and the 276/277 (Claim Status
inquiry/Response) are available on the State’s HSD website at:
http://www.hsd.state.nm.us/mad/5010HIPAAforNMMedicaidP
roviders.html
Or, they can be located by clicking on the link from the New
Mexico Medicaid Portal:
https://nmmedicaid.acsinc.com/nm/general/loadstatic.do?page=HIPAAInformation.ht
m
For more information or to sign up for the new transactions
please contact the New Mexico HIPAA Helpdesk at 1-800-2997304.
** NEW** NCCI (National Corrective Coding
Initiative)
Call Satisfaction Survey
Effective January 1, 2013, when calling the Xerox
helpdesks, providers will be asked if they would be
interested in participating in a short customer service
satisfaction survey. If the provider would like to
participate, the helpdesk representative will connect
you to the automated survey. If you have questions
regarding this, please contact Xerox at 800- 299-7304.
1
NCCI is a CMS program that consists of coding policies and
edits. NCCI edits are used in both Medicaid and Medicare. It is
important that providers understand that there are significant
differences between the Medicaid NCCI program and the
Medicare NCCI program.
Providers are encouraged to visit the Medicaid.gov NCCI
Program website, at the below link. This website contains
important information and updates on the program along with
the PTP and MUE edit files, so providers may review the correct
coding guidelines for specific procedure codes if they so wish.
http://www.medicaid.gov/Medicaid-CHIP-ProgramInformation/By-Topics/Data-and-Systems/National-CorrectCoding-Initiative.html
Basic Billing Training Webcast
Tuesday, February 12, 2013
Xerox will be conducting a basic billing webcast on Tuesday, February 12, 2013. Any provider many attend any session
listed below. Please review the Introduction to Medicaid Training, on the New Mexico Medicaid Web Portal before attending
these sessions. Providers do not need to sign up prior to this webcast. Please follow the instructions below, to attend.
Please contact the Provider Relations Helpdesk at 800- 299-7304 with any questions.
10:00am-10:45am
Medicaid School Based Basic Billing / Provider Enrollment Questions
11:00am-12:00pm
New Electronic Transactions
(Please include individuals that process electronic claims)
1:30pm-2:30pm
CMS-1500 Basic Billing
3:00pm-3:45pm
UB-04 Basic Billing
Meeting Information
Go to: https://acs-inc.webex.com/acs-inc/j.php?ED=183144697&UID=1341065822&PW=NOWRiYTFhMDNm&RT=MiM1
Meeting Number: 792106532
Enter your name and email address
Enter the meeting password: 3890454
Click “Join”
Follow the instructions that appear on the screen
To join the teleconference (Audio): Conference toll-free phone number: 1.877.931.2768
Participant access code: 3890454
Be sure to log in and call in so you have both the video and audio portion at the same time.
Enter the meeting password: 3890454
Click “Join”
Follow the instructions that appear on the screen
To join the teleconference (Audio): Conference toll-free phone number: 1.877.931.2768
Participant access code: 3890454
Be sure to log in and call in so you have both the video and audio portion at the same time.
Technical Support
If you have a technical issue logging in or during the WebEx sessions, contact the support desk at:
Verizon Net Tech
1.800.475.5500
Choose option 1 for Net Services
Then option 2 for Net Technical Assistance
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NM MEDICAID EHR INCENTIVE PROGRAM
UPDATES
for information on how to count Medicaid and Needy Individuals
encounters, and how to calculate individual and group patient
volume.
$ 46.8 Million Paid in NM Medicaid EHR Incentive Payments
Get Paid for 2012
The New Mexico Medicaid EHR Incentive Program has paid out
$ 46.8 million to 961 Eligible Professionals and 29 Eligible
Hospitals through the end of December 2012.
The New Mexico Medicaid Electronic Health Records (EHR)
Incentive Payment Program would like to remind Eligible
Hospitals and Eligible Professionals of the key attestation dates
for Program Year 2012. The dates apply to providers who are
participating in the program for the first time and attesting to
Adopt, Implement or Upgrade (AIU) certified EHR technology,
and to providers who have successfully completed AIU and are
attesting to Meaningful Use.
For a one-page summary of basic EHR Incentive Program
information, click on the applicable link below:
EHR Program Basics for Eligible Professionals
EHR Program Basics for Eligible Hospitals
For program eligibility and registration information, visit the New
Mexico Provider Outreach Page at http://nm.arraincentive.com/ .
Medicaid EHR Dates for Eligible Professionals

March 1, 2013 – Last day for Eligible
Professionals to attest to receive an incentive
payment for Calendar Year 2012 under the NM
Medicaid EHR Incentive Program.
Medicaid Enrollment Review – MAD 220 Form
Eligible Professionals (EPs) participating in the NM Medicaid
EHR Incentive Program and EHR practice administrators
coordinating EHR attestation on behalf of EPs are advised that
the Medicaid Enrollment of each EP attesting in the NM
Medicaid EHR Program needs to be reviewed to determine if a
MAD 220 Form is needed for the State to issue the incentive
payment.
During the CMS Registration and Attestation System process,
an EP has the option of paying himself/herself the incentive or
assigning the payment to a business, group practice or clinic in
which the EP practices. If the EHR payment has been assigned
in a manner not currently captured in the NM Medicaid
Computer Payment System, completion of a MAD 220 Form
may be necessary so the state can issue the incentive payment
as assigned by the EP.
1.
Click on Enrollment Review to determine if the EP
needs to complete the MAD 220 Form to enable the
state to make the EHR payment as assigned. The
MAD 220 Form is also available at this site.
For assistance with the MAD 220 Form, call 1-800-299-7304.
Choose option 5, then choose option 2.
For more information and to register, visit the New Mexico State
Level Registry (SLR) Provider Outreach Page at
http://nm.arraincentive.com
“Group Administrator” to the Rescue – Eligible
Professionals
If you have been tasked with coordinating registration and
attestation for multiple providers who are eligible for the New
Mexico Medicaid EHR Incentive Program, the Group
Administrator function in the New Mexico State Level Registry
(NM SLR) will rescue you from duplicative data entry, save you
valuable time, and help you expedite payments for your group.
Group Administrator is a “must use” function for any practice
or clinic:

whose eligible professionals (EPs) choose to use Group
Patient Volume as proxy for the EPs in the group;
and/or

will have one representative entering data in the NM SLR
on behalf of two or more EPs.
Calculating Patient Volume for Eligible Professionals
When attesting for each Payment Year, Eligible Professionals
(EPs) must meet a minimum 30% Medicaid patient volume
threshold for all patient encounters over a continuous 90-day
Representative Period in the prior calendar year. EPs practicing
predominantly at a FQHC or a RHC may use Needy Individuals
encounters to meet the 30% patient volume threshold. Under
certain conditions, EPs may choose to use their group patient
volume as proxy for their individual patient volume.
To expedite payment, assure that the patient volume calculation
is correct. Click on Patient Volume for Eligible Professionals
3
Group Administrator is the only approved method by the NM
Medicaid EHR Incentive Program for someone other than the
eligible professional to enter the data for attestation.
Sign Up for a “Group Administrator” Demonstration
If you would like the NM Medicaid EHR Incentive Program to
conduct a walk-through demonstration on how to use the Group
Administrator function in the NM SLR for you and your group
practice or clinic, email Valorie Vigil, EHR Program
Communications Manager, at Valorie.Vigil@state.nm.us.
Attention Anesthesia Services Providers:
Mass Adjustments are underway for claims with dates of service
12/01/2010 through 02/28/2012, and will be showing up on your
Remittance Advice throughout the next few weeks. Please be
aware there were several claims that made it through our first
wave of adjustments which may have underpaid due to an
incorrect units conversion. If these claim adjustments appeared
on your 11/30/12 remit, these claims will be identified and
readjusted at the appropriate unit amount.
Upon completing the adjustments for dates of service through
02/28/2011, the claims for dates of service 03/01/2011 through
10/13/2011 will be submitted for adjustment. This will complete
the mass adjustment project related to the anesthesia services
program policy and reimbursement methodology changes that
were implemented 12/01/2010. Thank you for your patience
during this process.
Electronic Funds Transfer (EFT) is required
As stated in section NMAC 8.302.29, the Human Service
Division, Medical Assistance Division policy requires payment to
be made only via electronic funds transfer (EFT).
NM PR Support Emails


It only takes 4 steps:
Step 1: Log in to the New Mexico Medicaid Portal as the
Master Administrator.
(In the Links on the left hand side, click on Email/EFT
Administration)
Step 2: Enter your EIN or SSN in the marked box.
Step 3: You will need to fill in the following:
- Account Type
- Account Number
- Bank Routing Transit Number
- Email Address
Step 4: You will then receive a confirmation of completion.
For additional assistance please contact the HIPAA helpdesk
at 800-299-7304.
4

Provider sends escalation (with corresponding Call
Reference Numbers) emails to
NMPRSupport@XEROX.com
1 business day – Email received, response sent to
provider (see below)
2-3 business days – provider receives inquiry status
If the provider does not receive a response/ status update,
the provider may call in with the CRN (Call Reference
Number).
 Provider Relations Specialist will provide status of
inquiry
 Status – Not Started, In Progress or Completed
THANKS FOR READING THE NEW MEXICO MEDICAID
NEWSLETTER
If you would like to receive this newsletter by email, send
request to NMPRSupport@XEROX.com and we will add you
to the list. For Web Portal, PayerPath & EDI issues, email:
HIPAAHelpdesk@XEROX.com