We have been noticing that since the beginning of the year we have been getting paid less than half of what our usual contracted rate is for residential substance abuse treatment. Has anyone else been experiencing this? Do you know if there is new contracted rates?

Can someone explain automatic adjustments? I've noticed that they appear out of no where. Why are they popping up and how are they getting the information? Last month, I had to clean up many patient accounts for statements because the adjustments were everywhere.

Any information is appreciated.

Thank you!

Has anyone in the past used Care Credit or another medical credit card for clients to apply for and then they use that for paying for services, or if they accrued a large balance, have them apply for it then they would owe Care Credit the balance and not your clinic? I know now that we have the Vault feature that this could perhaps take place of a care credit type of card.

Thanks in advance.

Is anyone else having issues with Availity-specifically with UCare?  I have an entire invoice that was never received by UCare and I have verified eligibility, credentialing and everything else I can think of, resubmitted the entire invoice both in entirety and also in several smaller invoices (client by client) and the information is just not reaching UCare.  Also, the interest isn't carrying over on my ERA's, when I actually get them.  So far I have had 4 ERA's this year that were never loaded into Procentive and I am getting frustrated.  A representative at UCare just told me about a clearinghouse called MN E-Connect.  Thoughts?  Suggestions? 

Hello!  Has anyone else had this happen today?  There were 4 different ERA's I posted this morning, and now they have disappeared in the ERA Module.   There was 1 ERA I hadn't posted yet, and it's no longer there.

Anyone else have the issue of trying to refund a client account in Procentive, and it will not pull up the client?
Does it matter if the payment is in a 'closed period'?

Question:  Does anyone require their clients to store a credit on file, at your office, in case they get behind on their balance?  If, so do you automatically run it for the agreed amount?  Is this ethically ok to do?

Good morning!  I am wondering if anyone has advice on managing the process of reimbursement rate changes from our various payers.  Do you rely on the bulletins that are sent out or do you just watch the EOBs to know if/when rates change?  Or do I need to be going online and watching fee schedules?  If you are able to respond and let me know how this is done at your organization I would be grateful.

Thanks & have a great day!

Jill

Has anyone else received their letter/invoice from BCBS in regards to the overpayment of Medicaid claims that were paid at a CMHC level, incorrectly? And is so, what is your plan to identify and "internally" re-process ALL of the affected claims?

Is anyone else missing ERA's from BCBS from this past weekend? I normally get some decent sized ERAs and have not yet received BCBS commercial and only a smaller than normal Blue Plus.