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MN MA Eligibility

Deb Fitz hace 7 años en Billing/Electronic Modules 0

Is anyone else having an issue with Eligibility?   We keep getting a clearinghouse error after it has ran from DHS.

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Multiple service locations and a Central billing location

Paula hace 7 años en Billing/Electronic Modules actualizado hace 7 años 2

I received a letter, this week, from DHS stating that they have not received any claims, for the past 12 months, for one of my locations, so they are terminating the enrollment for that location.  I bill weekly to DHS  for this location.  After lengthy phone calls and wait times, DHS is suggesting that the Procentive Billing Provider Loop 2010AA, Segment NMI, N3 and N4 need to be listed as the location of service and not our Central Billing location address... has anyone else received one of these letters and if so, what did you do about it?  

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substance abuse disorder

Deb Fitz hace 7 años en Billing/Electronic Modules actualizado por sarah hace 7 años 1

I was wondering if any providers have ran into issues with billing when the diagnosis of a substance abuse disorder was listed.  I know it cannot be listed as a primary diagnosis. I would think as long as it is not a primary diagnosis, it shouldn't impact reimbursement.  

Has anyone ran into issues with this?

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UCare Claims issues

Ashley hace 7 años en Billing/Electronic Modules actualizado por Chris hace 7 años 4

Has anyone been having issues with UCare claims for outpatient substance use disorder?  We have been struggling with this issue since Oct. 2016 and UCare doesn't have any answers for us for this main reason:  claims continue to reject and don't even reach UCare.  I've tried sending claims on both UB04 and CMS 1500 forms, I've changed the "Facility" under the client's Admissions tab from "13" to "89", and I've made sure to include both taxonomy codes (even though the first claims were sent before this was a requirement in March 2017)...I'm feeling at a loss of what to do now as we didn't have these issues prior to Oct. 2016.  We don't encounter UCare much, but now I have two more clients with UCare who are starting services.  Any advice?


P.S.  The following is the error/rejection message I get from Procentive in  the X12 Claim Data:  

Message Text:Category: Acknowledgement/Returned as unprocessable claim  The Claim/Encounter has been rejected and has not been entered into the adjudication system Status: Processed according to contract provisions (Contract refers to provision that exist between the Health Plan and a Provider of Health Care Services)

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Billing a ITP and FA on the same day

Can one provider bill a Individual Treatment Plan and another provider bill Functional Assessment on the same day?

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Coping DL or ID cards

Tanya Milner hace 7 años en Billing/Electronic Modules actualizado hace 7 años 7

I have been told that we need to copy a clients DL along with Insurance card when they come in as new clients. I have a client who has refused and doesn't want her DL copied. Is there something that I can show her in writing that we are required to get this. She called BCBS and was told she does not need to provide this to us. I need to get back to her on this, any thoughts or suggestions?

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BCBS Rejected claims

Deb Fitz hace 7 años en Billing/Electronic Modules actualizado por Pat Stream hace 7 años 4

All of our  BCBS electronic billing files rejected with the error "Submitter not approved for electronic claim submissions on behalf of this entity
 Entity: Submitter"  Anyone else experiencing this?


Respuesta
Pat Stream hace 7 años

Good morning!  

Our Support Team has opened a case with the clearing house about this issue and they're currently waiting for a response. I will post a reply here once we know the issue and resolution.

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Tricare revenue codes for Residential Treatment

Shondell hace 7 años en Billing/Electronic Modules actualizado por anonymous hace 7 años 11

Has anyone else billed Tricare for Residential Treatment?  No matter what revenue code I use, Tricare is rejecting my electronic claims and I cannot get them to go through.

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interactive complexity

Lisa_i hace 7 años en Billing/Electronic Modules actualizado por LWright hace 7 años 6

Hi all, Not sure I'm posting this in the correct forum. I'm looking for some information about coding for interactive complexity for clinicians doing play therapy. When adding this to 90837 or similar service line, do other clinicians typically record notes for both service lines or is a note for only one (or the other sufficient)? Our interactive complexity codes got denied and they were added at the same time as the main service code but notes were only included with the 90837 line so wondering if that was the problem. Any help with this would be welcome.