TRIBAL PEER RECOVERY SUPPORT SPECIALISTS (PRSS) OKLAHOMA BILLING PROCESS PRSS APPLIES FOR A NATIONAL PROVIDER IDENTIFYING (NPI) NUMBER
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The PRSS will need to be sponsored by an employer to take the PRSS training and complete a certification in order to apply for a NPI. To create a NPI, go to: https://nppes.cms.hhs.gov/# Scan the QR code for the NPI Guidance Document
PRSS IS CREDENTIALED THROUGH OKLAHOMA HEALTH CARE AUTHORITY (OHCA)
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The NPI number will be received through email (usually a short turn around). Your company's billing department will get the PRSS credentialed for Medicaid billing through OHCA. Once the PRSS gets their Medicaid number, the billing department will link the individuals Medicaid number to the agency Medicaid number.
BACKDATING TO APPLICATION DATE
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Generally, OHCA will back date approval to the date of the application to be a Medicaid provider was sent. (Example: You sent an application to OCHA on 1/2/23 and they did not respond until 4/2/23, they will back date the approval to 1/2/23.)
ENTER PRSS CODE INTO ELECTRONIC HEALTH RECORDS (EHR) SYSTEM
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Once OHCA approves the provider, the PRSS code is entered into the company's EHR system. Code: Comprehensive Community Support Services, per 15 minutes until H2015
OMB REIMBURSEMENT RATE All-Inclusive Rates (AIR or the "OMB rate") will be used per session.
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For questions about the reimbursement rate, click on the following link: https://oklahoma.gov/ohca/providers/types/behavioral-healthand-substance-abuse-services/behavioral-health-and-substanceabuse-services.html
For more information, email info@spthb.org