Travel Voucher Updates: Requests & Documentation

May 2019

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AK Medicaid Travel Vouchers and the processes around them are being updated! • You now have multiple ways to request voucher forms • It is now quicker and easier to request voucher forms than ever • You will be notified when your request is received and when your forms are

shipped • Voucher form requests submitted with complete information will be fulfilled within 2

business days • Voucher forms will be sent using certified mail for delivery confirmation • The voucher forms have been updated in several ways

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New Voucher Adoption Timeline

• New voucher forms go into use July 1, 2019 • Between July 1 and September 30 of 2019, both the new and old voucher forms

may be used for travel claims • After September 30, 2019, old travel vouchers will no longer be accepted for

payment of travel services

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Overview

• Voucher Request Process Changes • Issued Voucher Documentation Requirements • Travel Voucher Completion • Further Information

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Voucher Request Process Changes

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Voucher Request Process Changes

• New order forms have been created and posted for provider use in the process • Documentation and control processes are being implemented at Conduent to aid in this

process • Beginning on July 1, 2019, providers will need to record use of issued travel vouchers to

allow AK Medicaid to better control and account for travel voucher forms • Documentation of previously issued voucher use will need to be included with requests for

additional vouchers to justify new requests

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Request Form

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Request Submission Information • Information required on all requests includes:

– Provider name and Medicaid ID# – Requester name and contact information – Address to which vouchers should be delivered – Number of vouchers requested

• Reorder requests will also need to include documentation on the use of previously issued vouchers, to include: – Voucher or invoice number – Date issued – Who issued the voucher – Medicaid member ID/Name – Applicable prior authorization number – Service type (hotel/taxi) – Accounting of lost, destroyed or damaged vouchers

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Request Submission Options

• Email request with all required information to Aktravelvoucher@conduent.com

• Call Provider Inquiry to request forms at 907.644.6800 (option 1,1) or toll-free at 800.770.5650 (option 1,1,1)

– Follow the prompts to order vouchers

– If you are calling outside of business hours, leave a voicemail and you will receive a response within 1 business day

• Fax your request to 907.644.8126

• Mail to: Conduent | P.O. Box 240808 | Anchorage, AK 99524-0808

mailto:Aktravelvoucher@conduent.com

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Voucher Request Processing

• You will receive a confirmation communication when your request is received

• If there are any discrepancies with your request you will be notified

• When your vouchers are being shipped, you will be notified of the ship date and the tracking number for your shipment

• Vouchers will be sent using certified mail – you will need to sign for them to receive your shipment

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Voucher Request Processing

• Conduent recommends that providers request voucher forms 4 weeks in advance of anticipated need to allow time for requests to be processed and vouchers to be mailed

• It is also recommended that providers order a 2 month supply • Conduent will review all travel voucher requests and will:

– Review/document the travel voucher requests for completeness and accuracy – Communicate request discrepancies to the requesting organization and log the

communication with relevant details within 24 hours or next business day – Archive submitted travel voucher log files for review and surveillance – Reconcile the requests with prior shipped travel voucher volumes – Prepare, log and send shipment within 24 hours of approved travel voucher requests or

next business day

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Safeguarding Vouchers

• As previously, please continue to keep issued travel vouchers secure – treat them as you would a checkbook or a prescription pad

• Do not issue blank or extra vouchers to members • Keep vouchers in a secure location • Please report any missing vouchers to Conduent or the State of Alaska immediately • When issuing vouchers to patients, please remember to give original vouchers. – copied,

scanned, faxed, or emailed vouchers will not be accepted and are not valid for payment

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Issued Voucher Documentation Requirements

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Voucher Use Documentation Requirements • Providers should use the Transportation/Accommodation Voucher Request Log spreadsheet to record

information about the vouchers they are issued • This information will need to be submitted with requests for additional vouchers • Required information includes a minimum of:

– Voucher or invoice number – Date Issued – Who issued the voucher – Medicaid member ID/Name – Applicable prior authorization number – Service type (hotel/Taxi) – Additional column for lost, destroyed or damaged vouchers

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Voucher Log

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Voucher Completion

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Voucher Completion

• Voucher forms have changed! ‒ Vouchers are no longer carbonized form packs – each voucher is a one page document ‒ Each voucher has its own serial number ‒ Vouchers are printed on tamper resistant paper

• Methods and requirements for filling in travel vouchers for your patients have not changed • Vouchers should still only be issued to members after service authorization for travel has

been obtained • When issuing vouchers to patients, please remember to give original vouchers. – copied,

scanned, faxed, or emailed vouchers will not be accepted and are not valid for payment • The next several slides are a review of proper documentation needed on the travel

vouchers you are issuing to your patients

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Travel Voucher Completion • Check for Eligibility. Check the box, initial on the line, and enter date verified • Patient's Name (field 1): Enter the patient's first name, middle initial and last name • Patient's Date of Birth (field 2): Enter the patient's date of birth in MM/DD/YYYY format • Was Condition Related To (field 3): Check appropriate boxes for patient’s condition • Recipient Identification Number (field 4): Enter patient’s 10-digit Alaska Medical Assistance

identification number • Patient’s Sex (field 5): Select appropriate box indicating patient’s gender

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Travel Voucher Completion • Address (field 6): Enter patient’s address and telephone number • EPSDT Referral (field 7): If travel arrangements are being made because of an EPSDT (Early and

Periodic Screening, Diagnosis, and Treatment) screening, select Yes • Prior Auth Number (field 8): Enter the approved service authorization number • Authorized By (field 10): Enter the name of the person at the authorizing agency that authorized the

services. If you submitted the request through Health Enterprise, enter the User ID next to “A-Approved” status

• Acknowledgment (field 9): The individual submitting the travel service authorization must sign and date in this field, whether called in or submitted via Health Enterprise

* The Service Authorization number and Authorizing individual must be annotated for transportation/accommodation providers to get reimbursed!

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Travel Voucher Completion • Transportation (field 11): Enter the village or city where the

patient will begin travel in the Origin field; enter the city the patient is travelling to in the Destination field

• Round Trip (field 12): If round trip, enter the departure date and return date; if one-way, use field 13 instead

• One Way (field 13): If one-way trip, enter departure date; if round trip use field 12 instead

• Procedure Code (column 17) and Description (column 18): These fields are preprinted; if the code you need is not on the form, enter the code on one of the blank lines in this column with the corresponding description in column 18

• Units (column 19): Enter the unit(s) authorized for the specific service • Remember that a separate form must be created for each unit,

even if the same company provides the service • The only exception is lodging and meals if the units will be

rendered by the same provider continuously

Provider Notice: Do not complete the Charges column, (column 20). This is reserved for the transportation/ accommodation provider after services have been rendered.

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Travel Voucher Completion • If an escort is authorized, fill in the Escort portion of the AK-04;

otherwise, very clearly “X” out the entire escort portion rendering that section void.

• Transportation (field 14): Enter the escort’s first and last name accurately

• Round Trip (field 15): May be different from patient depending on individual needs and circumstances. If round trip, enter the departure date and return date; if one-way, use field 13 instead

• One Way (field 16): If one-way trip, enter departure date; if round trip use field 12 instead

• Procedure Code, Modifier, and Description (column 21-23): All allowable codes are preprinted

• Units (column 24): Enter the unit(s) authorized for the specific service

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Travel Voucher Completion

• As a reminder, do not fill out charges for the units you are requesting • The fields at the bottom of the form, shown below, are for the transportation and

accommodation provider to complete – medical providers, do not enter your information in this area of the form

05 13 2019 05 13 2019 $23.17 $23.17

Awesome Taxi Company 123 4th Ave, Anchorage, AK 907-123-4567

8675309

AK Heart Institute 5/13/19 3:15 Airport 5/13/19 3:40

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Member Information

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Additional Information

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Additional Resources • Alaska Medicaid Health Enterprise website at http://medicaidalaska.com

– Information necessary for successful billing

– Provider Manuals, including Arranging Member Travel

– Provider updates - http://manuals.medicaidalaska.com/docs/updates.htm

• You may also call:

‒ Eligibility only – 907.644.6800, Option 1,2 or 800.770.5650 (toll-free), Option 1,1,2

‒ Billing questions and all other inquiries – 907.644.6800, Option 1,1 or 800.770.5650 (toll-free), Option 1,1,1

http://medicaidalaska.com/https://na01.safelinks.protection.outlook.com/?url=http://manuals.medicaidalaska.com/docs/updates.htm&data=02|01|Marilee.Reinhart-davieau@conduent.com|783c1f25210d4b5c82ab08d6782dea2b|1aed4588b8ce43a8a775989538fd30d8|0|0|636828536885887446&sdata=qyLnyeIqxPRvmT6mGNe56S8JhHqECRQvC%2B2IUyH/LBg%3D&reserved=0

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Travel Voucher Updates: �Requests & DocumentationSlide Number 2New Voucher Adoption TimelineOverview�Voucher Request Process ChangesVoucher Request Process ChangesRequest Form Request Submission InformationRequest Submission OptionsVoucher Request ProcessingVoucher Request ProcessingSafeguarding Vouchers�Issued Voucher Documentation RequirementsVoucher Use Documentation RequirementsVoucher Log�Voucher CompletionVoucher CompletionSlide Number 18Travel Voucher CompletionTravel Voucher CompletionTravel Voucher CompletionTravel Voucher CompletionTravel Voucher Completion Member Information�Additional InformationAdditional ResourcesSlide Number 27