Rural Health Clinics (RHCs): Submitting Claims with Correct Place of Service Code

Posted February 14th, 2011 by mfoster & filed under Newsroom, Provider News.

As Magnolia continues to work with our network providers to ensure a smooth transition into Magnolia Health Plan (Magnolia), we have discovered many Rural Health Clinics (RHCs) have been submitting claims with a place of service code of “11-Office”. 

Magnolia follows the Centers for Medicare and Medicaid Services(CMS) guidelines for receiving and processing Medicaid claims which designates claims for services rendered and submitted from RHCs to be billed with the place of service code of “72-RHC”.  Claims previously submitted with the incorrect code of “11-Office” have been denied by Magnolia for the use of an incorrect place of service code.  If your RHC has used the incorrect code, you will receive an explanation of payment (EOP) indicating the cause for the claims denial.  Because Magnolia wants to ensure timely payment of all claims received, previously submitted claims that have denied for this reason will need to be resubmitted within 45 days of the EOP.  

We apologize for any inconvenience that this billing policy may have caused.  Again, we appreciate our partnership with RHCs in Mississippi and having them as a part of the Magnolia provider network.  Please feel free to contact our office at 1-866-912-6285 at your convenience should you have any additional concerns or questions.  Our friendly, local provider services staff will be happy to assist you.

Thank you

Magnolia Health Plan, Inc.