Here is a list of things to do now that you are here.
1. Personalize Your Profile In the upper right-hand corner, click your username and choose "User profile" to complete your name, add a photo ("avatar") and title, and set a Password.
2. Review Community Guidelines click here
3. Post & Participate Present your thoughts & ideas to generate discussion and responses from other Procentive Users!
Upcoming Holiday: Closed on Friday, October 10th for World Mental Health Day
In honor of World Mental Health Day on Friday, October 10, Ensora Health will be closed. Emergency support is still available at 877-288-5583.
Medicare Outpatient Adjudication Info:
Do not know what this field is actually supposed to contain when entering a Medicare or Medicare Advantage plan into a patient's payer - not finding anything at CMS either. Anybody have an idea???
checking claim status indicator
I was told by a Medical Assistance rep that we need to have a claim status of 16 when billing a Medicare Advantage plan to MA...I am not sure how to make this happen...ideas or suggestions???
MA denials for missing other plan information
We are consistently getting denials from MA when billed as secondary saying "missing other plan informaition" - specifically when primary is Medicare or a Medicare advantage plan. The COB is correct and have tried adding the svd segment manually, nothing works. Any ideas?
Clinical Trainees billing Optum Plans with the U5 modifier, DQ qualifier
Hi Everyone,
I am wondering how you all are handling this transition of new Optum payers that have been added so that we can send the U5 modifier with the DQ qualifier for our clinical trainees. Specifically, if you have a clinical trainee and a licensed provider seeing the same client with one of the payers that procentive split so clinical trainee and licensed people are billing different payers in procentive.
Any feedback on this change would be appreciated!
Customer support service by UserEcho
