(A) Claims for services provided to
managed care plan (MCP) enrollees, including requests for prior authorization
by an MCP of a federally qualified health center (FQHC) service, must be
submitted in accordance with Chapter 5160-26 of the Administrative
Code.
(B) In claims submitted to the department
for all other services, an FQHC must include the following data:
(1) The designated
procedure code for an encounter;
(2) The appropriate
modifier to specify the FQHC service; and
(3) Additional codes
representing all procedures performed during the encounter, along with any
required modifiers.
(C) In claims submitted to the department
for supplemental payment for services provided to an MCP enrollee, an FQHC must
also include the following data:
(1) The name of the MCP
that paid for the FQHC service;
(2) The identification
code of the MCP, assigned by the department;
(3) The MCP payment plus
amounts received from any other third-party payers; and
(4) Any other
information, such as an adjustment reason code, that is necessary for the
coordination of benefits.
(D) The department must pay a valid claim
for supplemental payment within four months. However, no supplemental payment
will be made for a claim that is not submitted to the department within the
limits specified in rule 5160-1-19 of the Administrative Code.
Rule 5160-28-07.1 | Cost-based clinics: alternate payment method (APM) for determining FQHC payment.
4 pages
Franklin County Ohio Clerk of Courts of the Common Pleas- 2015 Mar 26 12:52 PM-15CV001576 0Cc402 - E45 IN THE COURT OF COMMON PLEAS FRANKLIN COUNTY, OHIO OPRS Communities, d/b/a Westminster- ) Case No. 15 CV 001576 Thurber Community, ) ) Judge Richard S. Sheward Plaintiff, ) ) v. ) ) ORDER Dolores Baker, ef al., ) ) ) Defendants. ) This case came on for consideration this 20th day of March, 2015, upon Plaintiff's Motion for Preliminary Injunction. The Court finds said Motion to be properly s…
4 pages
Franklin County Ohio Clerk of Courts of the Common Pleas- 2015 Mar 26 12:52 PM-15CV001576 0Cc402 - E45 IN THE COURT OF COMMON PLEAS FRANKLIN COUNTY, OHIO OPRS Communities, d/b/a Westminster- ) Case No. 15 CV 001576 Thurber Community, ) ) Judge Richard S. Sheward Plaintiff, ) ) v. ) ) ORDER Dolores Baker, ef al., ) ) ) Defendants. ) This case came on for consideration this 20th day of March, 2015, upon Plaintiff's Motion for Preliminary Injunction. The Court finds said Motion to be properly s…
2 pages
FILED MARY L. SWAIN BUTLER COUNTY CLERK OF COURTS IN THE COURT OF COMMON PLEAS 01/08/2020 03:07 PM BUTLER COUNTY, OHIO CV 2019 08 1668 Otterbein Homes d/b/a Otterbein Senior Life) CASE NO. CV 2019 08 1668 f/k/a Otterbein Middletown, LLC, ) ) JUDGE Michael A. Oster, Jr. Plaintiff, ) ) JUDGMENT ENTRY v. ) . ) Shirley Wellman, ef al., ) Defendants. This case came on for consideration this day of , 2019 upon Plaintiff's Motion for Default Judgment pursuant to Civ. R. 55(A). The Court finds said M…
Butler County, OH
Jan 08, 2020
CIVIL - GENERAL
3 pages
ELECTRONICALLY FILED COURT OF COMMON PLEAS Wednesday, February 10, 2016 8:32:20 AM CASE NUMBER: 2016 CV 00342 Docket ID: 292615…
Montgomery County, OH
Feb 10, 2016
DECLARATORY JUDGMENT
5 pages
ELECTRONICALLY FILED COURT OF COMMON PLEAS Friday, September 11, 2020 2:00:40 PM CASE NUMBER: 2020 CV 02955 Docket ID: 34888129…
Jul 29, 2020
CLOSED
Montgomery County, OH
Sep 11, 2020
PERSONAL INJURY
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