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Virginia Health Care Association | Virginia Center for Assisted Living

CCC Plus: DMAS Announces Process for Resolving Outstanding Claims

CCC Plus: DMAS Announces Process for Resolving Outstanding Claims

As we shared with nursing center members on March 8, VHCA-VCAL has worked closely with the Department of Medical Assistance Services (DMAS) to find a solution to help members receive payment for outstanding accounts receivable (AR) under CCC Plus.  As a result, DMAS has secured agreement from the six Managed Care Organizations (MCOs) to resolve these outstanding claims for custodial and specialized care by the end of March.

Nursing centers (or companies, by facilities) should begin work using the provided Excel form to provide each MCO its AR by Friday, March 16, 2018.  Please share this information to your billing/AR staff.

Click here to read the letter form DMAS Director Jennifer Lee outlining the project.

VHCA is appreciative of Director Lee and the DMAS staff for initiating this requirement on the plans to rectify past-due CCC Plus claims in a time certain.

Instructions for Submitting MCO-Specific Information

  • DMAS is requesting that facilities (or company, by building) provide each MCO its AR on a standard Excel form no later than Friday, March 16, 2018. Click here to access the Excel spreadsheet. (Note: the spreadsheet includes a specialized care tab for facilities providing that care.)
  • The MCO-specific information is to be provided electronically via encrypted email to the relevant MCO. (As a reminder, to comply with HIPAA, you may not send Personal Health Information (PHI) unencrypted.)
  • Each MCO will be providing submission instructions in the near future. VHCA will share that information as soon as it is available. In the meantime, we urge you to fill out the information so you are ready to submit it when the encryption information is provided.

While the MCOs are required to rectify issues with CCC Plus claims, the only way to hold the MCOs to the March 31 deadline is for your facility(ies) to provide the AR information requested by the March 16 due date.

Secondary Claims Update

Please note the AR project is for CCC Plus only (not CCC – the Dual Demonstration) and only includes custodial Medicaid claims and Medicaid specialized care claims for those relevant providers. This request does not include any Medicaid secondary claims. VHCA, DMAS, and the MCOs continue to work on fixing secondary claims and more time is required by the plans at this point. DMAS indicates they will be monitoring the progress in processing these claims.

If you have any questions or concerns, please contact Steve Ford at steve.ford@vhca.org