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Effective: December 1, 2006 |
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28.10.05ar1 - Fee-for-Service Delivery System (Archive) |
Archived: June 1, 2009 |
In a fee-for-service (FFS) delivery system, people may receive their Medical Assistance (MA), General Assistance Medical Care (GAMC), or MinnesotaCare services from any provider who is enrolled as a Minnesota Health Care Programs (MHCP) provider. Providers bill DHS for each service provided. DHS makes payments for approved services at a predetermined rate.
MA and GAMC enrollees who are not enrolled in receive health care services through the FFS delivery system. MinnesotaCare enrollees do not receive care through FFS on an ongoing basis, but may use the FFS system for a limited period in some circumstances.
For MHCP enrollees whose coverage is delivered through FFS:
l They obtain health care services from an MHCP provider by presenting their MHCP membership card.
l DHS pays claims directly to the provider.
l Enrollees receive an each month showing the FFS claims DHS has paid on their behalf.
To receive payment through the FFS system:
l Providers must be enrolled with Minnesota Health Care Programs (MHCP). Refer providers who request information about enrollment to the MHCP Provider Call Center at 651-431-2700 or 1-800-366-5411.
l The service must be covered by the program in which the person is enrolled. Providers receive detailed information about covered services in the MHCP Provider Manual. Information is also available through the Eligibility Verification System (EVS) or the Provider Call Center.
For further information, see: