KNOWN ISSUE:  Workflow Tasks are triggering retroactive workflows.  Our engineers are currently evaluating this issue.  We will update you when this has been resolved.  If you have any questions please send a ticket to Procentive Customer Support.

Thank you,

Rachael Smith

Onboarding and Implementation Team Manager

The Minnesota payers BCBS/Blue Plus, SCHA/MMSI, and UCare are making updates within the next 2 months.  We will provide you with more details mid-November, but here’s what you should do now: 

Blue Plus PMAP (of MN)

The Change: 

• BCBS is creating a new Payer ID number for Blue Plus PMAP to distinguish it from Blue Plus Commercial plans.
• As of December 1st, 2018, all PMAP claims will need to be submitted to a new Payer ID number.
• Procentive will automatically update the Payer ID in the new payer Blue Plus PMAP on December 1, 2018.

Action Required: 

• Add the new payer "Blue Plus PMAP" (ID: SB720) to the Payers Module. Copy over current codes and rates from the BCBS PMAP payer.
• Add the new payer to each client that has BCBS PMAP and begin using this new payer right away.  (Run Report 3070 in the Reports Module to see a list of all clients with BCBS PMAP.)
• Inactivate the old BCBS payer for each client as you add the new one. 

SCHA/MMSI

The Change: 

• SCHA/MMSI’s Payer ID will change as of December 1, 2018.

Action Required:

• Fill out the Electronic Funds Transfer (EFT) form you receive from SCHA/MMSI.  
• DO NOT fill out the Electronic Remittance Advice (ERA) form that they send you.  
• At this time no change within Procentive is needed. 

UCare

The Change: 

• UCare is creating a new Payer ID for UCare Family and Individual (currently called either UCare Choices or Fairview UCare Choices), effective as of January 1, 2019.
• Procentive will automatically update the Payer ID in the new payer UCare Family and Individual on January 1, 2019.

Action Required: 

• Add the new payer "UCare Family and Individual" (ID: 52629) to the Payers Module. Copy over current codes and rates. 
• Add the new payer to each client that currently has either UCare Choices or Fairview UCare Choices. (Run Report 3070 in the Reports Module to see a list of all clients with these payers.)
• You will need both the old and new payers for a client because the payer you submit to will depend on the Date of Service.  

Have further questions on what to do to prepare for these changes? Please submit a ticket to the Procentive Care Team.

Greetings to user group members interested in telehealth services.

There was a previous group discussion about telehealth that included concern about BCBS of MN's policy, which specifically excludes covering telehealth services provided when the recipient is in their home. This obviously is a problem because their PMAP product, Blue Plus, must be in compliance with DHS guidelines and DHS specifically states that telehealth services provided when the recipient is in their home is a covered benefit. 

So, I knew that BCBS's policy was a problem.  I tried to work with a BCBS representative, who basically hemmed and hawed, eventually acknowledged that their Blue Plus policies needed to comply with MCHP policies, but nothing changed. This took a couple of months. So,  contacted DHS last week, she requested a copy of my email discussion thread with BCBS, and a few hours after I sent this into  I had a call from a BCBS staff. . She asked a few questions and promised to get back to me "soon." The  next day I had another call from her. She was very apologetic, acknowledged that their policy was wrong, and she specifically stated that we can bill BCBS Blue Plus for telehealth services when the member receives them in the home. 

This leaves some questions about other BCBS "commercial" policies.  She said that most of their commercial products cover telehealth services but it will be necessary to check each contract to make sure that is not an exclusion for telehealth when the recipient is in their home. 

Richard Sethre, PsyD, LP

Procentive will be undergoing a scheduled maintenance window this weekend between 11 PM (CDT) Saturday, October 27 - 3 AM (CDT) Sunday, October 28.

The system may be unavailable intermittently during this maintenance period. We are only anticipating minutes of downtime but the scheduled window will last 4 hours. 

Thank you for your patience as we continue to improve our system.

I am wondering if there is any new info or ways agencies are able to start billing for professional staff being added to their agency. From what I have read we should not be having a fully licensed staff billing under another professionals license as they wait to be added as it may be fraudulent. I am wondering though how agencies deal with that?  We just waited about 6 weeks just to add a licensed staff to our agency with most insurance companies  who was already credentialed . How do agencies deal with this?

Is anyone else using a separate software to track and work denials? If so, what are you using and how do you like it?

If you are solely working denials within Procentive, are you tracking these on a spreadsheet, running a report?

Today (Thursday, 10/18/2018) at about 10:10 AM [CST] Procentive will log out all users.  This action is being taken to fix several bugs that were accidentally introduced this morning which are continuing to affect loading times. If we wait to address this your experience in Procentive will continue to decrease, we want to resolve this for you this morning. Please be aware of the following and communicate with other users within your agency in case they have not signed up for this email list:

• If you have a form open, be sure you save it before 10:10 AM [CST].

We apologize for any inconvenience. If you have any questions, please feel free to contact Procentive Support.

KNOWN ISSUE:  If you have Tickets displaying in the Client Dashboard, an error message will pop up when accessing the Dashboard.  You can simply close the error and use the Dashboard as normal.  This issue is currently being addressed by our engineers.  If you have any questions or comments please send a Ticket to Procentive Customer Care and Support.

Thank you,

Rachael Smith

Onboarding and Implementation Team Manager