Does anyone bill their Rule 25 Assessment with a HF Modifier?

This was just brought to my attention that for PMAPs (UCare/Hennepin Health) we can bill the Rule 25 with the Modifier and bill the Comp Assess without it. The R25 would pay per our contract and the Comp Assess would pay the 162.24.

Any feedback would be greatly appreciated. 

I am having an issue of OP CD  sending as an admit to discharge on the UB04. I am not sure what setting to add to avoid this and not have to edit that each time. My understanding is you have to send with an admit date as they are in a specific program. Any advice is much appreciated. '

The only setting I could see that would help this is editing the "outpatient" to "inpatient" under residential so the claims sends with its proper 862/863/864 etc. 

Thanks! 

Is anyone else experiencing delayed payments for institutional claims with Blue Plus and Ucare?

Hello,

Wondering if our outpatient groups are entering time for just over 45 min. Can we bill the hour? Or how do we edit this ? 

I know with mental health there is a approved "gap" if it is greater than x amount of time you can choose the appropriate code. 

Wondering what that is for OP CD group. 

Hello - we have been billing Treatment Coordination (T1016 HN U8) for a handful of months and now want to look into billing this service when client is not present. 

I know that we are able to do this but have some questions I am hoping someone can provide some insight into:

1. Since the client is not present as long as it is noted appropriately it should not be seen as duplicate billing? i.e. the client is in group at the same time the TC is being completed without them present.

2. If TC is occurring through out the day in smaller increments can we bill for 1 unit if it totals 15 minutes? 

3. Any clinical documentation guidelines outside of the norm?

Thank you - Jeremy RL

I just noticed that the payer id for DHS looks different. Says MNMAG? What is this all about? And for some strange reason I am unable to open the data link in the Billing Module for any claims generated today. When I click on the data link, I either one or two error pages open instead.

Thanks, Sara

Does anyone bill out 99408 and 99409 It is a public health approach to screening and early intervention to help identify, reduce and prevent substance use.  If so, have you been successful with getting paid? Thank you

Hello,

Was anyone else effected by the 1002 Room and board value code/CPT code change? 

We bill out for enhanced rate for both medical and w/ child  OR 1002 w/ Medical and they did not give a value code for those option/ combinations. Only on the 1003 code. 

That state has not contacted me back yet and this is a significant amount of money ! Curious if any one has heard back / had the issue as well. 

Hello,

We are continually having problems with getting paid by Federal BCBS plans for residential treatment with room & board. Do any of you providers bill this payer and what codes are you using?

Hello,

I have updated primary payer from Medicare to HealthPartners PMAP.

I did the wrong payer adjustment in payments module and used drop down to queue claims to HealthPartners PMAP.

# 1 the queued claims are now showing in the billing module

# 2 claims show 0 balance

I'm new to procentive so any help would be great. I need to get these claims billed out to HealthPartners.

Thank you