Is anyone else having problems submitting claims to South Country?

Hello! At the beginning of the year, all of our Blue Plus clients received new Policy Group Numbers and Individual Policy Numbers. I tried to input these numbers along with the new payer Id for BCBS of MN - PMAP and it was rejected in the system in Procentive. Procentive is not able to read the new subscriber numbers. Is anyone else having this issue? Any feedback would be greatly appreciated! :)

Hello, 

We have been made aware of the issue in regards to claim rejections occurring in the Electronic Module for UCare claims submitted to the payer ID 52629. 

We are currently working with the clearing house, and payer in order to determine what the cause of the rejection is on their end. Please hold off on submitting claims at this time. We will alert you when we receive a resolution and determine if all claims need to be re-sent at that time. 

Thank you,

Amanda Kafumann

Customer Care and Training Specialist 

We have instances where additioinal documentation is regularly needed for a claim - I know there is some way to send a faxed claim attachment with a referral number, but have not tried it.  Has anyone had experience with this and how successful was it?

We are not Medicare enrolled practice-wide.  Most of our practitioners are LMFT, which Medicare does not cover any way.  We don't seem to get a straight answer from private (commercial) insurance about whether we can bill with the GY modifier or some other method to bypass Medicare and bill them.  Any help????

Does anyone have any input on codes; 99050 or 99051? These are "after hours" billing codes, from what I understand. 

Thanks, Sara

KNOWN ISSUE:

Some claims submitted to SCHA Payer ID 81600 and MMSI Payer ID 41154 through Claim Lynx are returning with an Error Status since 12/04/2018.

Claim Lynx has informed Procentive that this is an error with the Payers.  They are evaluating this issue and working towards a fix by end of day 12/07/2018.

According to Claim Lynx if you have received the status of error, you do not have to resend your claims.  The claims have been received by Claim Lynx and will be processed by the payer once this issue is resolved.

If you have further questions please contact Procentive Customer Care via ticket.

I have inherited a problem with BCBS commercial plans when billing 1002 and H2036 HA, HH. We bill multiple units for each and on a invoice I have noticed that they are reimbursing as for the Room and Board however they are NOT reimbursing us correctly for treatment services.  When I called BCBS they stated this was because of a date range issue however I have been told by Procentive that is not accurate and that I need to remove the HCPCS code from the claim.  

Does this sound familiar to anyone? what do you do to get your claims paid?  I have noticed that we have been taking LARGE adjustments on H2036 and would greatly appreciate hearing what worked for you to get your claims paid.