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Rate Changes

KatieW 4 years ago in Payers Module updated by Shauna Dall 4 years ago 4

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.

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Blue Cross Commercial Minnesota

BillingAS 1 month ago in Payers Module updated 2 weeks ago 4

Is anyone else having claims for Blue Cross MN commercial rejecting this week that worked last week? All my claims went through last week but now every single one is rejecting for payor ID. Payor ID we are using is SB720.Thanks! 

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Bypass Medicare and Bill PMAP for Residential Substance Abuse

Jackie Waara 1 month ago in Payers Module updated by Jen 1 month ago 2

Hi! I am brand new to Residential billing. I have a Residential SUD Facility that is not JCAHO or CARF certified. I have a patient who has Medicare as primary and UCare PMAP as secondary.  For SUD OP services we bypass Medicare and bill Ucare as primary.  Does anyone know if I can do that with Residential SUD as well? Or do all patients who have Medicare as primary have to go to a JCAHO/CARF facility? 

Thanks!
Jackie

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Primewest billing supervisor required

sadie.twite 10 months ago in Payers Module updated by Mark Cornell 10 months ago 3

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!

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Update for Medica IFB payer ID

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.

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MN Care tax exemption for specific plans within payers

crystalp 1 year ago in Payers Module updated by Susan Davis LICSW 1 year ago 1

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.

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Assessments for Medicare clients

sadie.twite 3 years ago in Payers Module updated by Tracy Filipi 3 years ago 2

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.

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Which payers require a CLIA code on claims?

crystalp 3 years ago in Payers Module 0

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.   

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Submitting services to Office of Justice Programs Crime Reparations Board

Rochelle Garcia 3 years ago in Payers Module updated by Laura Hulsey 3 years ago 1

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

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Blue Cross Blue Shield of North Dakota

vpetrik 3 years ago in Payers Module 0

Does anyone know the Payer ID number for Blue Cross Blue Shield of North Dakota as of 1-1-2019?

Thank you,

Victoria Petrik