When billing through MN-ITS, there's a very handy feature that pretty much guarantees no sent claims will be denied. If I bill in MN-ITS, before sending the claim, I have the option to "Validate" each claim to ensure there are no errors. If after validating a claim finds an error, I immediately get notified of the error code, so I can fix, re-validate, and resend when no errors are found.
This has been extremely helpful to ensure predictable cash-flow when billing, and completely eliminates the possibility of errors when sending in claims.
Is it possible for something like this to be implemented in Procentive?
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Ucare is denying Residential claims due to no Value 24 Code being listed on the claim. After speaking with Ucare, a number of times, we are continually hearing that V24 code has to be in box 39 on the UB-04 claim. Is anyone else being told this?
Procentive is telling us that V24 codes can only go out on MA claims.
Are we alone in this issue?
We have been receiving some information/advice on how to properly bill for a comprehensive assessment and also bill for intakes in our new chemical dependency program.
Our thought is to use code H0001 for the comprehensive assessment itself, but we have also been advised that there should be a billing for group time.
Can anyone provide some insight on why group would be billed as well? If billing for time spent on the comprehensive assessment is allowed, shouldn't that be billed as individual?
Thought this might be helpful... I've added the authorization # of 88888888888 to the authorization field for our MA payer and submitted claims for Direct Access services, and they show as set to pay. I know from talking with others there were ideas around adding a new payer in order to accommodate one payer that can include authorization numbers on claims (Rule 25 clients with SA #s) and a separate payer that can exclude authorization numbers on claims (Direct Access clients)..
DAANES authorization numbers default to 8888888888 and using that on claims seems like it will work, allowing one MA payer, where Rule 25 clients can have actual SA #s (as they always did) and Direct Access clients can have the default authorization number of 88888888888.
Has anyone else attended the DHS trainings regarding direct access billing and/or DAANES entry changes?
It looks like there are going to be many changes in order to bill MNITS for 1002, H2036 and H2035. Is Procentive aware of these changes and updated the software accordingly?
We have enrolled in Medicare (only one provider so far...) and need to determine if we need any modifiers for regular mental health codes, and/or how documentation is provided to Medicare if needed - anyone been billing Medicare and have some insight?
I received notification that codes H0031 & H0032 will only be able to be billed as 1 unit and must have the modifier "UD" removed as of 01/01/2019. MHCP posted a bulletin about these changes:
"The Centers for Medicare & Medicaid Services (CMS) has established a Medically Unlikely Edits (MUEs) of one unit for HCPC codes H0031 (mental health assessment by non-physician) and H0032 (mental health service plan development by non-physician) beginning Jan. 1, 2019. MUEs prevent payment for an inappropriate quantity of the same service on a single day. Currently, more than one unit is allowed for each of these codes when the UD modifier is included. The UD modifier will no longer be required and only one unit of each of these services will be allowed per day for Managed Care Organizations (MCOs) and fee-for-service claims beginning Jan. 1, 2019. Minnesota Health Care Programs (MHCP) will deny a claim line that includes more than one unit. MHCP will determine a per-session rate for H0031 and H0032 and will reprocess paid claims with dates of service beginning Jan. 1, 2019, once a new rate is established. (pub. 12/28/18, rev. 1/8/19)"
Since our claims are currently being denied, I contacted MN-ITS provider help desk to inquire about this. Essentially they have no answer as to when the rate for 1 unit will be decided, or what that rate will be.
Has anyone come up with a decent conclusion how to bill for these properly? Provider help desk did say they will automatically resubmit all claims that contain 1 unit.
Thanks in advance
Customer support service by UserEcho