Hello,

I am curious if anyone has taken advantage of the new Minnesota statutes that allow three psychotherapy sessions to be billed before a DA is complete?

My problem I am running in to is what billing code to choose that will be accepted by the state. Since there is no diagnosis yet, staff have been billing Z codes, but I am not sure if psychotherapy will be reimbursed for Z code diagnoses.

Thanks,

Chris

KNOWN ISSUE: There was recently an Apple update that affected Safari. Due to this update, Time Add is not populating staff name or client name. If you refresh your window, the information populates. Otherwise, you are still able to select staff name and client name manually by typing in the first initial of the staff name. Once you select the staff name, the client list will populate. We are continuing to research this issue and will update this page once we have more information. 

Hello,

Not Procentive related but I feel this is a great place I can come to for support on the administrative side of things.  Im wondering if anyone is aware or knows of any billing/coding trainings held in the area that are specific to mental health codes.  Ive worked with mostly CTSS codes which are pretty straight forward but as our practice starts to offer new services Im hoping for support on billing more private pay payers. 

Idea...Can Procentive's Bill Care offer any Billing Trainings???

Thanks

Rochelle 

Have any other clinics been experiencing issues of getting booted out to sign in screen when working in Procentive?  We have been experiencing issues in both Chrome and Internet Explorer where we get booted out of Procentive while working, so in the middle of scheduling an appointment, typing a clinical note, or applying payments.  It seems like it is happening often late morning and in the afternoon intermittently?  We check our internet connection and we are staying connected to our programs which operate on a Remote App server so we need internet connection for those programs and are not loosing connection with that, so we don't feel it is on our end.  Just curious if anyone else is also experiencing any of these issues as well?  Thank for your feedback.

Good morning!  

I have heard from several people that Zoom meeting is HIPAA compliant and insurances cover Zoom sessions.  Does anyone know if this is accurate and how to go about billing for these sessions?

Thanks & have a great week!

Jill

Hi Everyone!

Procentive has received quite a few questions in regards to EIDBI services, billing DHS, provider registration, and other aspects of this type of care. 

We've had the opportunity to speak directly with Nicole Berning the Autism Policy Lead at Minnesota Department of Human Services (DHS) who was able to answer the most common questions we received. 

Please review the Questions and Answers (Q&A) from Nicole below. If you have any additional questions please contact DHS, submit a ticket to the Procentive Support Desk, or ask other providers on the User Community.

Q: If I have an NPI, why do I need to get an UMPI?

A: Good news - you don't! If you have an NPI you are no longer eligible for an UMPI as the criteria are mutually exclusive (source).

Q: How do I know if I qualify for an NPI or an UMPI?

A: Please review "NPI & DHS: Frequently Asked Questions" (source).

Q: Where do I go to obtain an NPI?

A: Use the National Plan & Provider Enumeration System (NPPES) to enroll for an NPI (source). Help with enrollment is available from NPPES (source).

Q: Don't I have to bill with an UMPI for EIDBI services?

A: All billing to DHS requires a licensed professional to be submitted on the claim, with their registered type 1 NPI, as either the rendering provider or the supervising provider. If you have an NPI you are not required to also obtain and bill with an UMPI.

Q: I'm registered with DHS under my UMPI, can I just use that?

A: As outlined in the Provider Requirements section of the MHCP Provider Manual, any changes in enrollment must be submitted to DHS (source). This includes obtaining a type 1 NPI.

Q: If I can use my UMPI, what is the benefit to obtaining and using an NPI?

A: With DHS, increases in certifications may change your provider level. A lower level provider with an UMPI (e.g. Level 3) may receive less reimbursement for services than a higher level provider with an NPI (e.g. Level 1) (source).

Q: What criteria are used to determine a provider level?

A: The types of providers and their criteria are outlined in EIDBI Provider Overview (source).

Q: I've heard about EIDBI and I think I qualify. Where do I get more information?

A: A great place to start is the EIDBI section of the MHCP Provider Manual (source) or the EIDBI Benefit Policy Manual (source). 

If you have a client whose secondary payer allows more than the primary payer and the secondary processes the claim by paying whatever the CCD was from primary but still owing CCD, do you charge the client or adjust it off, since the secondary covered a minimum of the CCD from primary? Ie. primary Health Partners has a lower allowed amount for a certain code than secondary BCBS. HP has a $25 co pay. BCBS pays the co pay, sometimes more, but then is also processing the claim with CCD up to the BCBS allowed amount (which in this case is pretty decent amount). Do you charge the client the difference or adjust it off since you were paid by primary and the secondary covered the CCD from primary? Thanks. sorry it's confusing to explain this.

Is anyone else experiencing substantial slowness with Procentive at this time?

Does anyone have any best practices that can be shared when it comes to the first of the year where benefits(not eligibility) need to be re-verified and releases in the client module need to be updated?

Currently, we end up with a tone of paperwork that ends up having to be scanned.

Thanks Much!

I've been noticing the last few Ucare PMAP ERA's have been denying every claim with a "UA" modifier. Is it something I'm doing wrong, or is it an issue with UCare? Anyone else been having these issues?