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Category: Idaho Medical

New Automated Preauthorization Request Form

New Automated Preauthorization Request Form

DMBA is pleased to announce a new automated Provider Preauthorization Request form. By using this tool, your preauthorization request will be processed promptly and efficiently. And you’ll have the convenience of submitting any supporting documentation online, as well. If you have questions about this information, please call Member Services at 801-578-5600 in the Salt Lake City area or toll free at 800-777-3622.

Denial of unclassified drug codes billed without the NDC

Denial of unclassified drug codes billed without the NDC

When billing unclassified drug codes (for example, J3490, J3590, J7199, J7599, etc.), the National Drug Code (NDC) is also required to identify the specific drug administered to the participant. DMBA uses NDC information to determine whether the drug meets the eligibility requirements of the participant’s medical plan. Beginning September 1, 2018, DMBA will deny charges for unclassified drug codes that are billed without the NDC, and the claim will need to be resubmitted with the NDC to be considered for payment. To avoid claim denials, please make sure that unclassified drugs codes…

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Free Seminar: HIPAA for the Small Provider

Free Seminar: HIPAA for the Small Provider

The U.S. Department of Health and Human Services is offering a free seminar July 25, 2017 in Salt Lake City. At this seminar, you will learn valuable information about HIPAA privacy, security, and breach notification rules. Please click here for more information.

E-prescribing data accessible through EMR systems

E-prescribing data accessible through EMR systems

Do you know about e-prescribing (electronic prescribing)? E-prescribing technology enables secure, bi-directional, electronic connectivity between physician practices and pharmacies. With e-prescribing, prescribers can send prescriptions to a participating pharmacy electronically instead of writing, faxing, or calling them in. Our providers have access to e-prescribing data through EMR systems. E-prescribing provides potential benefits: Improved legibility of prescriptions with reduced variation in the quality of prescribing Fewer prescribing errors, thus reducing potential adverse drug events Shorter wait times for members collecting their medications from…

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Preauthorization Guidelines and Forms Online

Preauthorization Guidelines and Forms Online

DMBA preauthorization guidelines and forms are now available on our website. Go to www.dmba.com and select Providers from the Related Sites dropdown menu. The preauthorization documents are located in Services menu. And for your convenience, they’re even fillable!

Happy New Year!

Happy New Year!

As we begin this new year, DMBA wants to remind you that we launched our newly designed website on January 3, 2017. We invite you to visit our new website at www.dmba.com. The Providers section is now located under Related Sites. You can request a fee schedule, update your information, enroll to receive electronic funds transfers (EFT), and find other helpful information under Services. Best wishes for a healthy and successful 2017!

Happy Holidays!

Happy Holidays!

The holidays are a time to reflect on the accomplishments and events of the past year and those who made a difference in our lives. This holiday season, DMBA would like to express deep gratitude for the exceptional service and care you’ve provided to our participants. You made a difference! We sincerely appreciate our partnership and look forward to our continued association with you. Best wishes for a wonderful holiday season and a very happy new year.

EDI Transactions: National Standards Save Time and Money

EDI Transactions: National Standards Save Time and Money

National standards for electronic healthcare transactions can save time and money. DMBA offers standard electronic transactions to providers upon request, including the following commonly used transactions: Eligibility and benefits inquiries and responses (270/271) Claims submission (837) Claims status inquires and responses (276/277) Electronic remittance advice and funds transfer (835)* * Enroll online at www.dmba.com.

Important Information About ICD-10 Unspecified Codes

Important Information About ICD-10 Unspecified Codes

At DMBA, we follow ICD-10 processing guidelines established by the Centers for Disease Control for “header codes” and “codes valid for HIPAA transactions.” Based on these guidelines, we must deny claims that use header codes. While these unspecified codes may be valid for billing HIPAA transactions, they don’t meet the appropriate level of specificity for supporting medical necessity. After last year’s implementation of ICD-10, DMBA offered a one-year courtesy grace period, allowing payment for claims billed with unspecified codes. Starting…

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