It would be helpful if Procentive had a feature to make rate changes apply automatically to all fee schedules on a specified date/time.
e.g. We are increasing several of our rates by a % on 1/1/18 so it would be nice to schedule the change and have it go into effect for DOS on/after 1/1. As it works right now, we will have to be extra careful checking each DOS to make sure it was billed out with the appropriate rate for 2017 or 2018.
We are continually getting the error "A supervisor with a valid NPI is required" for all our institutional Primewest claims. We have tried to fix this by adding a billing supervisor to all our LADC staff but the claims are still getting this error. Can someone tell me what they set up to get around this error? I believe it's something that needs to be added to the payer on the staff tab but we have tried several things and still get the same error. Thanks!
As of January 1, 2021, Medica IFB will have a new Payer ID (87726) . You will need to submit all claims for dates of service (DOS) on or after 1/1/2021 to this new Payer ID.
Please visit our Live Updates page for information regarding this upcoming change.
How does your clinic separate MN Care tax exempt payments paid by certain plans?
And, how do you know with certainty which plans are exempt? Or which programs are exempt?
Thank you in advance.
Does anyone know if you can do an assessment for a Medicare client and bill for it even if you are not a Medicare contracted provider? We are looking to just do the assessment and then refer to a Medicare contracted facility.
We are going to start billing for Urine Drug Tests for our COD program and we received a CLIA waiver. I see in the payers module > rates > codes tab that there is a filter that says "Use CLIA code on claim"...does anyone bill UDTs and send their CLIA code with claims? Do you know which payers require it? Would is be best to contact provider services for each payer or our network reps? Specifically, the code we will bill is 80305 QW. Thanks for any help as this is brand new to our clinic.
I was wondering if anyone has submitted claims to this program that pays for mental health services. They're requesting billing be submitted on HCFA 1500. They are not Procentive payer and so Im trying to figure out a way to not have to fill out these claims by hand. Thanks
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)
- 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.
- 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’s Payer ID will change as of December 1, 2018.
- 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 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.
- 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.
Minnesota Blue Plus PMAP 2019 Payer ID 00562 Update
We are aware of the issue with the incorrect Payer ID being sent on claims for some agencies. Upon further research into this for you this morning, we have determined the cause to be one of the following:
Option one– The original communication was missed regarding this change and the Blue Plus PMAP payer you have in your payers module is still set to the old Payer ID of SB720/00720.
SOLUTION– 1. Add the new payer with the payer ID 00562 for all Minnesota Blue Plus PMAP plans and copy over current codes and rates
from the BCBS PMAP payer.
2. Add the new payer to each client that had BCBS PMAP and begin using this new payer right away.
Option two– If the above is complete and you are still receiving denials then it is due to Procentive allowing them to be sent to the old payer ID. We have already fixed this to prevent this from happening as of 10:00 am cst today.
SOLUTION– Resend any 2019 claims which were previously sent prior to 10:00 am cst on 1/14/19.
If you have questions, please create a ticket so the Care Team may assist.
Customer Care & Training Specialist
Customer support service by UserEcho