AGING AND DISABILITY SERVICES ADMINISTRATION

2006 NH "Dear Administrator" Letters

October 25, 2006

ADSA NH #2006-026
Update To Change In Policy Regarding Third Party Liability
Payments On Behalf Of Medicaid Residents

Dear Nursing Facility/Home Administrator:

This letter is an update to Dear Administrator Letter #2006-020 and is informational only. This is the last letter that will be sent regarding implementation of policy changes related to Third Party Liability because the last insurance carriers will be changed to the new process on November 1, 2006. Enclosed is an updated list of frequently asked questions (FAQ’s) and responses. We expect that many people will have similar questions, so this format should help to answer many of the questions that you have.

The last group of insurance carriers will be changed to the new procedures effective November 1, 2006. These carriers are:

• Aetna,
• Cigna, and
• Any other insurance carrier that had not previouslymoved to cost avoidance.

You should have an updated copy of the Cost Avoidance Suggestions and Helpful Hints that was mailed in May. This updated packet will assist you in determining the best way to proceed in this endeavor. If you would like an additional copy or have specific questions on billing particular carriers, please call toll free (800) 562-6136. For patients with the last name beginning with letters A through G call Cyndy Mills at Ext. 51936 or for patients with the last name beginning with letters H through Z call Susan Pemberton at Ext. 51164.

Sincerely,

Ken Callaghan, Chief
Office of Rates Management
Aging and Disability Services Administration

Andy Renggli, Chief
Coordination of Benefits Office
Health and Recovery Services Administration