Sample notices of appeal are. found in FORMS (pages 13 and 14). Along with the notice of appeal, you will generally file these additional documents: a. pre-calendar statement, a copy of the order or judgment appealed from, any decisions. the order or judgment is based on, and an affidavit of service.
Accessing the Medicaid Interactive Web Portal. A secure logon to the Medicaid Interactive Web Portal is required to access the new attachment option. For new providers, Medicaid will send a letter containing a personal identification number (PIN) and other information on how providers can access the Portal.
In essence, this modifier indicates the CMHSP is billing Medicaid fee-for-service for a CWP beneficiary. To assure correct payment, the UC modifier must be reported on the first claim line, in the first position following the procedure code.