I saw this posted today and I hope many of you could utilize this during stressful times like now.
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Hopefully there will be more things that I can post on here to help out our overworked Health Care Professionals.
We here at Procentive appreciate everything you do!
Since the new year all of our claims have come back denied for contractual obligation (code 45). Even on clients that we did not have trouble with previously, we are now having issues with claims coming back this way. Mostly seeing this for code H2014 which is not covered, but we are not getting a denial that we can send to secondary.
I am wondering if there was an update or something that we missed and we are sending our claims to the wrong place? Has anyone heard anything?
If it matters, we preform outpatient mental health services in Minnesota.
We have had a nightmare of a time dealing with United Healthcare and the Optum side. Being one is behavioral health and the other is the actual insurance plan, you would think they communicate with each other.
Thanks in advance!
Good Afternoon everyone! I've been getting the run around, so I'm hoping someone has some advice.
I bill for a mental health facility in Minnesota. While looking online at our MN DHS website, I found a few different documents staying there are no copays for mental health visits.
I contacted the state, and the rep I talked with said that we are supposed to write off copays and deductibles for patients with MA or a PMAP. Spend downs not included.
This has put a lot of discussion into our office lately.
Has anyone heard of this? These patients' claims are being sent and coming back with a Patient Responsiblility, so I would assume that if they had no copay, they wouldn't use a PR reasoning code.
Any info is appreciated!
For any of you who are MN CTSS providers -
1. Has anyone had an unannounced site visit?
2. If you have more than one CTSS location, is each site individually certified for CTSS svcs?
3. For your Disclosure of Ownership form, who do you have listed as having "ownership" in your organization? (Board of Directors, President/CEO, supervisors, etc.)
4. Is everyone aware there is a state-approved interpreter list and only those interpreters are reimbursable by state funds?
Thanks in advance for your input!
Wondering if anyone has had a similar experience with billing the new 99417 code to MN MA DHS? It is being denied by MN MA DHS. We have called on the denial and the call center states it can't be added to 99205 or 99215. Which doesn't make sense as it was developed to only be added to those codes. It is paying fine for other Payers.... Thoughts?
For anyone interested or if this may apply to you, this information was passed along to us:
Over the past 30 years, the maternal mortality rate in the U.S. has doubled, with significantly higher rates among women from minority groups. Maternal health care providers can help eliminate these disparities by delivering the highest quality of care to all women.
OCR’s partner, the HHS Office of Minority Health, has launched a free, accredited, 2-hour e-learning program, which is designed for providers and students seeking knowledge and skills related to cultural competency, cultural humility, person-centered care, and implicit bias across the continuum of maternal healthcare. At a glance, the e-learning program allows participants to:
-- Learn how to improve your quality of care by understanding, respecting, and responding to a patient’s experiences, values, and beliefs;
-- Earn up to 2 continuing education credits at no cost;
-- Accredited for physicians, physician assistants, nurse practitioners, nurses, certified nurse midwives, and certified midwives;
-- Complete the program at your own pace; and
-- Enjoy a friendly learning experience, using case studies, self-reflection questions, and a Resource Library.Learn how to improve your quality of care by understanding, respecting, and responding to a patient’s experiences, values, and beliefs: https://thinkculturalhealth.hhs.gov/maternal-health-care.
Think Cultural Health is a website of the HHS Office of Minority Health that provides health and health care professionals with information, continuing education opportunities, and resources on how to provide culturally and linguistically appropriate services.
We have had a couple providers receive a letter from BCBS about their "higher than the expected billing distribution" for code 90837. It''s asks that the provider contact their "Provider Education Team" so they can "further understand your coding methodologies and billing practices."
Has anyone else received one of these?
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