State of Tennessee    Provider Claims Processing  

 

Department of Intellectual and Developmental Disabilities 
 

WARNING:   This is a Government computer application system and is the property of the State of Tennessee. It is for authorized use only. Any unauthorized use of this computer system and/or any attempt to gain unauthorized access thereto could constitute a violation of the Computer Crimes Act of the State of Tennessee. 

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News, Events and Announcements
Event  1) PCP IS NOW OPEN 
From  Tuesday, September 18, 2018 
To  Monday, September 24, 2018 
Details  PCP IS OPEN FOR CURRENT BILLING FOR DOS JULY 29, THRU SEPT 8, 2018. IT IS ALSO OPEN FOR LATE BILLS AND ADJUSTMENTS FOR DOS JUNE 10, 2018 THRU JULY 28, 2018. IT WILL BE CLOSED TUESDAY MORNING, SEPT 25, 2018 TO LOAD CALENDARS FROM SEPT 9, THRU SEPT 15, 2018.

IT SHOULD BE AVAILABLE AGAIN BY NOON CENTRAL TIME ON THE 25TH.

THE PCP Billing and TNCare Payment Schedule is available at http://tn.gov/didd/article/pcp-billing-and-tncare-payment-schedule

ALL BILLING, PAYMENT, AND PCP ACCESS QUESTIONS SHOULD BE SENT TO DIDD_Billing.ACR@tn.gov PLEASE INCLUDE ALL PERTINENT INFORMATION INCLUDING AGENCY NAME, REGION, SERVICE INDIVIDUALS NAME AND SS#, SERVICE AND DATES OF SERVICE SO THAT WE MAY SERVE YOU MORE EFFICIENTLY. 
 
Event  ATTENTION!!! IMPORTANT INFORMATION ON PCP STAFF DESIGNATIONS 
From  Thursday, August 18, 2016 
To  Sunday, June 30, 2019 
Details PLEASE CHOOSE ONLY ONE INDIVIDUAL FOR THE SUPERVISOR ROLE IN PCP. EACH AGENCY MAY HAVE ONLY ONE SUPERVISOR. AN EMAIL MAY BE SENT TO DIDD_Billing.ACR@tn.gov DESIGNATING A SUPERVISOR SUBSTITUTE DURING VACATION OR ILLNESS.

BILLING SHOULD NEVER BE ENTERED WITHOUT VERIFIED DOCUMENTATION. TO ENTER BILLING WITHOUT DOCUMENTATION IS FRAUD.

THE BILLING INDIVIDUAL DESIGNATED IN PCP AS SUPERVISOR SHOULD BE AN INDIVIDUAL THAT HAS THE ABILITY AND RESOURCES TO GUARANTEE THAT ADJUSTMENTS AND LATE BILLS ARE ENTERED ACCURATELY AND CORRECTLY, RESEARCHED WITH COMPLETED NOTES AND VERIFICATION ON WHY THE ADJUSTMENT IS BEING ENTERED.

ONLY ONE BILLING PERSON AT AN AGENCY WILL HAVE ACCESS TO THE ADJUSMENT/LATE BILL SCREENS. IDEALLY AN ADJUSTMENT/LATE BILL SHOULD NEVER BE CHANGED MORE THAN ONE CORRECTION OR PROCESSED WITHOUT VERIFIED "EYES ON" DOCUMENTATION. ENTERING SUBSEQUENT ADJUSTMENTS CAUSES FRAUD ALERTS, SYSTEM ERRORS, MISMARKED CLAIMS AND DENIED CLAIMS. 
 
Event  TENNCARE REMITTANCE ADVICE and BURST REPORTS 
From  Monday, September 10, 2018 
To  Sunday, June 30, 2019 
Details  The RA is the official document of record and should always match the check or deposit. RAs are available through the PDMS TennCare portal. The TennCare RAs for waiver payments should be filed for future reference and will be needed for various reasons, including audits. Duplicate RAs must be requested through TennCare.

DIDD develops the payment information file provided by TennCare into an ACR Excel spreadsheet which is distributed as a courtesy to providers. The ACRs are burst using an automated process as soon as they are available through a secure email system per HIPAA requirements. The ACR sent by DIDD may be manipulated for accounting purposes and is not the official document of record.

The ACR Excel reports will be burst by DIDD thru a secure email system to a generic email address, (not specific to any individual). This designated email address can only be changed through a letter emailed to DIDD_Billing.ACR@tn.gov written on agency letterhead and signed by the Executive Director or equivalent. It is the provider's responsibility to retrieve the file from the secure site within 14 days and distribute to necessary individuals as well as save for future reference. DIDD has received many requests to reproduce and resend ACRs. To eliminate duplicate work and ease administrative burden of these requests, DIDD will enforce a $20 charge for each ACR requested.

Voided Claims Reports are burst on Tuesdays and are initiated by changes to a cost plan. Contact the appropriate Regional Office with any questions on voided claims or cost plans to avoid timely filing issues. A new calendar will load into PCP and must be billed appropriately to receive payment. Billing on an invalid Cost Plan will cause a recoupment of any claims paid on the inappropriate billing.

Cost Plan Reports are burst monthly. Please review and contact the appropriate regional office as soon as possible to discuss an error, issue, or change. Billing on a calendar built from an incorrect cost plan could delay accurate payment. It may take several billing cycles to address and correct payments based on an erred out cost plan. Subsequent correct billing entered by the provider may appear to the system as duplicate billing and deny. Billing on an incorrect Cost Plan may be subject to review and audit for Medicaid/TennCare fraud.

DIDD uses secure email to send ACRs for non-waiver (state) funded services in both an Excel and PDF file. The PDF file is the report of record.  
 
Event  FINGERPRINT/BACKGROUND CHECKS AND ANCILLARIES 
From  Tuesday, September 12, 2017 
To  Sunday, June 30, 2019 
Details PROVIDERS MAY NOT BILL FINGERPRINT/BACKGROUND CHECKS OR ANCILLARIES IN PCP. BILLING IS HANDLED BY THE DIDD CENTRAL OFFICE BILLING AND PAYMENT STAFF.

TO INQUIRE REGARDING A PENDING PAYMENT FOR THESE PLEASE WRITE
DIDD_Billing.ACR@tn.gov.

PLEASE INCLUDE THE NAME OF YOUR AGENCY, THE AMOUNT OF EXPECTED PAYMENT AND SERVICE DATES.

DIDD_ Business.Services@tn.gov SHOULD BE USED TO SUBMIT BILLING DOCUMENTATION FOR FINGERPRINTS/BACKGROUND CHECKS.

Forms are available on the DIDD website under Providers - Forms and Tools - Office of Business Services.


 
 
 
Citizens Plaza State Office Building
400 Deaderick Street
Nashville, Tennessee 37243-1403