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.  

I have a few practitioners who are struggling to get client signatures after opening the signing window.  I've been looking at individual computers and it appears that nothing is wrong so does anyone have thoughts / suggestions?  I haven't sent a Ticket yet and just wanted to "poll" the community for thoughts. 

KNOWN ISSUE:

When sending a Fax in the Fax Module, a pop-up window detailing a SQL Error Message appears.  Please disregard this window.  

Faxes are still being sent and received.  

This pop-up window has already been addressed by our engineers and a resolution will be in place tomorrow.

Please send a Ticket to Procentive Customer Care if you have any questions.

Thank you,

Rachael Smith

Onboarding and Implementation Team Manager

Our facility has never billed secondary payers. I am trying to get this set up but seem to be struggling.

Can anyone share best practices, tips/tricks, workflows, lessons learned...?

Do you bill the secondary when you are posting the ERA/Payment via the ERA Module?

Do you do everything manual in the COB Tab?

...and getting reimbursed.

Thanks,
Kim

Is anyone currently billing or had any success in billing for assessments such as the PHQ, GAD, etc?

We are wondering if any clinic has successfully billed for the scoring and writing up the evaluations for ADHD testing, this would be without patient present of course.  What codes are you using?  We found code 96127, however most insurance companies are only allowing payment of $5.00-$10.00 which is extremely low for the amount of time the clinician is spending scoring and writing up the evaluation.  Any information you can provide is appreciated.

Any insight you have may help.  

An employer is reimbursing a patient for a copayment and they are requesting as of October 2018 DOS are now asking or the following on the receipt:

"The IRS asks to include on the receipt: Amount, Method of Payment, The Diagnosis code, Treatment Plan, and Dr's information: Name, facility and National Provider's Identifier."

I've provided the receipt from the copayment made the same day and the HCFA 1500, but the Treatment Plan, and Diagnosis Code?  It seems a bit excessive. I may be wrong about it.

Does Procentive have a report that can run all of the above on one form?