MyCare Implementation Update

The MyCare implementation in Ohio has been a bit of a challenge with the five different MyCare plans. However, we have successfully sent 837 files directly to Buckeye Community Health Plan, CareSource, United Healthcare Community Plan of Ohio and sent files through Emdeon for Aetna Better Health of Ohio and Molina HealthCare of Ohio. We have added new "ARBatch" billing processes for all MyCare payors using prescribed Medicaid and Medicare file formats, pricing, service coding and "roll and round" reguirements. The MyCare Medicaid processors contain the same actions as normal MITS billing including a preprocessor, file generator, query controls, detail file reporting and automated ERA remittance file posting.

We have been closely consulting with our agencies over their MyCare billing experiece to quickly resolve issues, refine the ARBatch MyCare Medicaid steps, troubleshoot any issues with regards to both the MyCare Medcaid or MyCare Medicare file processing, EDI submission, and 835 payment processing. Unfortunately, we have not had much experience as yet with returned MyCare 835 remittance files from all of the MCPs as Emdeon has been the only company to return an 835 thus far. As those 835 files come in, we will work to ensure that our ERA processor has no issues processing these claim payments. Please contact your account manager to have the MyCare package installed if we have not already done so.