Patient Administration

We realize that you perform administrative tasks related to patient care daily. We’ve consolidated information below to assist you with tasks such as verifying eligibility, making benefit determinations, acting in a manner that recognizes member rights and cultural differences, and considering alternative ways to deliver services.

Member Billing

TrueCare does not have copayments for CHIP members. Providers should not bill TrueCare members for covered services.

Covered Services

Regulations state that providers must hold members harmless in the event that TrueCare does not pay for a covered service performed by the provider unless TrueCare denies prior authorization of the service and the provider notifies the member in writing that the member is financially responsible. This must be done prior to providing the service, and the member must sign and date the notification.

Non-Covered Services

If the TrueCare member requests a service not covered by Medicaid, providers may charge the member for the service as long as the member has been told prior to receiving the service that it was not covered.

If the provider does not tell the member that the service is not covered until after it has been rendered, the provider cannot bill the member.

Missed Appointments

In compliance with federal and state requirements, TrueCare members cannot be billed for missed appointments. We encourage members to keep scheduled appointments and call to cancel, if needed.

Please call our Care Management department at 1-844-542-2610 if you are concerned about a member who misses appointments. TrueCare offers free transportation to medical appointments for both MississippiCAN and CHIP members.

Please call Provider Services at 1-833-230-2174 for guidance before billing members for any services.

Member Rights & Responsibilities

As a TrueCare provider, you are required to respect the rights of our members. TrueCare members are informed of their rights and responsibilities via their member handbook. Please review our members’ rights and responsibilities and ensure your practice is compliant.

Telemedicine

TrueCare covers telemedicine services to members. Please verify your patient’s coverage before referring a member to telemedicine services. When members cannot connect with their PCPs, telehealth technology makes health care more accessible, cost-effective, and can increase patient engagement.

Providers must follow Centers for Medicare & Medicaid Services (CMS) guidelines as well as state-level requirements.
All telemedicine claims for TrueCare members must be submitted to TrueCare with correct codes for the play type in accordance with applicable billing guidelines.