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Medicare Outpatient Adjudication Info:

Marsyl vor 12 Monaten in Billing/Electronic Modules aktualisiert von s beaulieu vor 12 Monaten 4

Do not know what this field is actually supposed to contain when entering a Medicare or Medicare Advantage plan into a patient's payer - not finding anything at CMS either.  Anybody have an idea???

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checking claim status indicator

Marsyl vor 12 Monaten in Billing/Electronic Modules aktualisiert vor 12 Monaten 2

I was told by a Medical Assistance rep that we need to have a claim status of 16 when billing a Medicare Advantage plan to MA...I am not sure how to make this happen...ideas or suggestions???

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We are getting UHC rejections on telehealth claims, ie 90837 GT with POS 10 - is UHC no longer requiring the GT

carrie vor 1 vor einem Jahr in Billing/Electronic Modules aktualisiert von ahuseby vor 1 vor einem Jahr 1
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MA denials for missing other plan information

Marsyl vor 1 vor einem Jahr in Billing/Electronic Modules aktualisiert vor 12 Monaten 15

We are consistently getting denials from MA when billed as secondary saying "missing other plan informaition" - specifically when primary is Medicare or a Medicare advantage plan.  The COB is correct and have tried adding the svd segment manually, nothing works.  Any ideas?

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Primary COB not traveling on MA 2ndary claims

s beaulieu vor 1 vor einem Jahr in Billing/Electronic Modules aktualisiert vor 1 vor einem Jahr 2

The 2ndary claims stopped rejecting.....but now the primary insurance COB isn't travelling on the MA 2ndary claims so MA denies for missing primary COB- when the COB is populated. Ahh!! help

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Location of Therapist??

Paula vor 1 vor einem Jahr in Billing/Electronic Modules aktualisiert vor 1 vor einem Jahr 1
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BCBS Federal Telehealth

Jill Benson vor 1 vor einem Jahr in Billing/Electronic Modules 0

Anyone receiving denials from BCBS Federal for DBT H codes done via telehealth?  We are getting pushback from them and lots of different answers for MH services in general done via TH stating these services need to be done through Teladoc.  

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Therapy Brand sign in

AmyB vor 1 vor einem Jahr in Billing/Electronic Modules 0

Is anyone having issues with signing into Therapy Brands? We are getting a message: "can't reach this page". This is also affecting E-Prescribe capability.

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Clinical Trainees billing Optum Plans with the U5 modifier, DQ qualifier

Nicole vor 2 Jahren in Billing/Electronic Modules aktualisiert von Kim N vor 1 vor einem Jahr 2

Hi Everyone,

I am wondering how you all are handling this transition of new Optum payers that have been added so that we can send the U5 modifier with the DQ qualifier for our clinical trainees. Specifically, if you have a clinical trainee and a licensed provider seeing the same client with one of the payers that procentive split so clinical trainee and licensed people are billing different payers in procentive.

Any feedback on this change would be appreciated! 

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Why is Medicare (and Medicare plans) denying all F43 dx codes?

Stephanie B vor 2 Jahren in Billing/Electronic Modules aktualisiert von s beaulieu vor 2 Jahren 5

Effective December, Medicare and plans are denying any F43 code (F43.1, F43.23 etc).