I need to get some of my therapists trained on these assessments. Currently DHS doesn't have any upcoming trainings scheduled for these. Any suggestions on how to get them trained?

Can anyone share their experience?  We are experiencing longer-than-ever wait times to get staff credentialed - in one situation we have a therapist with a simple change in location (joining our agency) that is at 17 weeks of waiting.....

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

Was kicked out of Procentive and unable to get logged back into Procentive for 10 minutes now.  Is anyone else experiencing this too?

Does anyone send in client wellness assessments to Medica after a client has been seen the first or second time? Also do you fill out the form on the Optum website that reports how many complaints you have had for the quarter from Medica clients?

I understand that we must accept payment in full, regarding billed claims, when our clients have a county insurance.  My question is.... is it permissible to directly charge a client, with county insurance, a fee if they Late Cancel and/or No Show.  We do have it addressed in our financial contract, which is signed by each new client.  

Anyone having issues with MN DHS Request Claim Status today? I've been trying to correct and submit claims through the mn-its site and I keep getting issues. Saying things like: Unable to process your request, etc. 

I have a certified yoga/nutritional/wellness coaching expert (certified) who is also trained in Yoga for PTSD. She does not have a Masters Degree and is not a therapist. I am wondering, if she is assisting in the treatment of PTSD/Depression/Anxiety can we bill under a licensed therapist for the time spent? If yes, would there be a different code other than a 90837?

I am picturing this only for sessions that are spent specifically to address symptoms associated with diagnosis. Not necessarily ongoing for just basic overall wellness. If that were the case I know it would be a cash/private pay situation.

Thanks!

Alyson 

I am following up on recent Procentive User Forum discussions about telehealth, in particular the question of whether insurance companies doing business in MN pay for telehealth when the recipient is in their home.  I am working my way through the local and national companies, and so far every company  has told me that they pay for telehealth when the recipient is in their home. 

The outlier is BCBS MN, which has a policy that clearly states that payment is limited to services provided when the recipient is located at "another facility.

I have had an interesting exchange with a BCBS MN representative.  He confirmed that they pay only for services provided when the recipient is in another facility, and not in the home. I pointed out, however, that DHS specifically covers telehealth when the recipient is in their home, and BCBS has a PMAP contract which requires them to cover DHS benefits. He acknowledged this and said that he would "have to research this further." I have not heard back, but it has only been a week and I expect that he will have to work with others at BCBS internally to sort this out. 

Stay tuned.

Hello all!

I am having issues with one specific client who has a UHC private and DHS secondary. We are billing IOP services. The UHC denied for medical necessity up front but since DHS covers our services, we figured they would just be billed as secondary, especially since we had that physical denial.

The EOB's have been coming back from UHC stating "contractual obligation" instead of "patient responsibility." Due to this, secondary will not pay.

Has anyone else had this issue? Do you have any solutions?