Telehealth continues to evolve

From the Center for Connected Health Policy, CMS just released new guidelines for telehealth, including some changes for what I prefer to call telehavioral services. 

The guidelines include,

"Beginning July 1, 2019, the SUPPORT Act will add the enrollee’s home as an eligible originating site and remove the originating site geographic limitation on existing eligible telehealth originating sites (including the home) when treating for a substance use disorder or co-occurring mental health disorder through telehealth." 

So, at least for SUD/co-occurring treatment, things are continuing to evolve. 


UHC/Optum Claims

TessaLasky 2 years ago in Industry News/Discussion updated by sarah 2 years ago 2


Since the new year all of our claims have come back denied for contractual obligation (code 45). Even on clients that we did not have trouble with previously, we are now having issues with claims coming back this way. Mostly seeing this for code H2014 which is not covered, but we are not getting a denial that we can send to secondary.

I am wondering if there was an update or something that we missed and we are sending our claims to the wrong place? Has anyone heard anything?

If it matters, we preform outpatient mental health services in Minnesota.

We have had a nightmare of a time dealing with United Healthcare and the Optum side. Being one is behavioral health and the other is the actual insurance plan, you would think they communicate with each other.

Thanks in advance!


Medical Assistance Mental Health Copay Write off?

Good Afternoon everyone! I've been getting the run around, so I'm hoping someone has some advice.

I bill for a mental health facility in Minnesota. While looking online at our MN DHS website, I found a few different documents staying there are no copays for mental health visits. 

I contacted the state, and the rep I talked with said that we are supposed to write off copays and deductibles for patients with MA or a PMAP. Spend downs not included. 

This has put a lot of discussion into our office lately. 

Has anyone heard of this? These patients' claims are being sent and coming back with a Patient Responsiblility, so I would assume that if they had no copay, they wouldn't use a PR reasoning code.

Any info is appreciated! 

Thank you!



Sheryl Martin 2 years ago in Industry News/Discussion updated by StephB 2 years ago 9

Can anyone share what system/program you are using for telehealth appointments?  Pros, cons?  Thank you in advance!



MN CTSS agencies - unannounced site visit questions

Jana Judisch 2 years ago in Industry News/Discussion updated by Suzette Mallum 2 years ago 4

For any of you who are MN CTSS providers -

1. Has anyone had an unannounced site visit?

2. If you have more than one CTSS location, is each site individually certified for CTSS svcs?

3. For your Disclosure of Ownership form, who do you have listed as having "ownership" in your organization?  (Board of Directors, President/CEO, supervisors, etc.)

4. Is everyone aware there is a state-approved interpreter list and only those interpreters are reimbursable by state funds?

Thanks in advance for your input!


Credentialing, as newly licensed, with Insurance Companies for two different Mental Health Centers

Paula 3 days ago in Industry News/Discussion 0


I have not run into this before.  One of our therapists will soon be fully licensed.  He works for our company and also for another mental health company.  Is there any reason why he cannot credential to all insurance companies with two separate applications?  One application listing our company and our billing NPI # and sending in another application listing the other company and their billing NPI#?




patient check-in/digital receptionist app or software for iPad?

Kyle 3 months ago in Industry News/Discussion 0

We are looking for a really simple digital receptionist app or software, and wondering what folks are using?

We have an ipad kiosk and looking for something really simple, so that clients can walk-up, check-in and feel confident that they're provider has been notified.


SDQ and CASII Documentation

Paula 5 months ago in Industry News/Discussion updated by sfoster 2 months ago 10


Question:Are SDQ and CASII's still required?  I never see any communication with DHS, once we submit. Are you completing for only MA clients or all PMAP clients? 


Multiple PMI numbers

Rochelle Garcia 5 months ago in Industry News/Discussion updated by Shauna Dall 5 months ago 5

I was just wondering if anyone knows of another site other than MNITS to check insurance eligibility (besides individual PMAP sites).  Im finding that many clients have multiple PMI numbers and unfortunately on MNITS you will just get the response:

  • Invalid/Missing Subscriber/Insured ID.
    Please Correct and Resubmit."

When I've called DHS before one person explained that this error may mean there is more than one PMI and the next time I called I was told they were not supposed to give us this information.  Most of our client's are in home clients and its difficult to get a hold of parents to get any insurance information from them. How does this corrected? I've sent claims to Hennepin County and they have been returned as having an active PMI but again I dont have this new information so how can providers know this.  


Professional Liability Insurance

Leah T. 5 months ago in Industry News/Discussion 0

Reaching out to see if anyone is willing to share what company (not agent or agency) they have professional liability insurance through.