14 Continuing with FQHCs & RHCs. In some FQHCs and RHCs will not have Specialty instances, like BH, FQHC and RHCs have a Codes. Please see the response to #13. provider type code, but no map to Spec Code. If FQHCs and RHCs crosswalk to PCPs, OB/GYN using both PT and Spec Code how can it be mapped to BH if it doesn't map to a specialty code? 15 For BH, Provider Type 31 - Psychologist isn't No, Provider Type 31 has a single specialty mapped to a Spec code. Should it be mapped code, so there is no need to map to a to 62 - Psychologist? specialty code. 16 We noted that there are several crosswalk HHSC is revising the crosswalks to match maps where an MD maps to a DO and vice Medicaid provider enrollment (provider types versa - a DO to an MD. These have rejected in and specialties). HHSC will be working with our P92/94s. Should these be updated and Maximus to update the EB CHIP Joint MDs map to MD and DOs to DOs only? Interface Plan to ensure consistency.
14 Continuing with FQHCs & RHCs. In some instances, like BH, FQHC and RHCs have a provider type code, but no map to Spec Code. If FQHCs and RHCs crosswalk to PCPs, OB/GYN using both PT and Spec Code how can it be mapped to BH if it doesn't map to a specialty code? FQHCs and RHCs will not have Specialty Codes. Please see the response to #13. 15 For BH, Provider Type 31 - Psychologist isn't mapped to a Spec code. Should it be mapped to 62 - Psychologist? No, Provider Type 31 has a single specialty code, so there is no need to map to a specialty code. 16 We noted that there are several crosswalk maps where an MD maps to a DO and vice versa - a DO to an MD. These have rejected in our P92/94s. Should these be updated and MDs map to MD and DOs to DOs only? HHSC is revising the crosswalks to match Medicaid provider enrollment (provider types and specialties). HHSC will be working with Maximus to update the EB CHIP Joint Interface Plan to ensure consistency.
20170626_MCO_QA.DOCX