Does anyone know if a patient has MA or a PMAP as a secondary and their commercial primary denies for timely filing how I can send to secondary to receive payment?

I just got off the phone with a commercial insurance plan as I was checking on denied claims for a patient. This patient has MA has a secondary. The commercial primary is denying due to the COB box on the electronic claim was checked yes. Commercial insurance rep told me that if a patient has Medicaid/Medicare that box can't be checked yes. Can someone please help explain this to me and why? Where is that box in Procentive? I have numerous denied claims for numerous patients with this same issue?

THANK YOU!

Hello - I noticed that sometime last week MN DHS updated there Telehealth Billing (COVID) section to show that we should be billing with POS Office and Modifier 95. Up until recently we have been billing under POS Office with no modifier as that was the original direction given by DHS. Note, we were not a Telehealth Provider prior to COVID. 

Has anyone else been billing CCDTF with POS Office WITH Mod. 95????

Thank you - Jeremy

Has anyone been able to successfully bill and receive payment for the Comprehensive Assessment ($162.24) with HealthPartners PMAP? 

Jeremy

Wondering if anyone has come across this scenario yet.....we have clients coming into the office and being seen via telehealth. When submitting claims w/ place of service (pos) office, no modifier is needed; for telehealth a modifier is needed for most payers. Currently, I have to look in the Appointment Module to see which clients are coming into the office so I know to change the pos to "office" ( right now, I only have Telehealth pos available for providers as that is the majority). Unfortunately, I added the telehealth modifier when I billed them. Anyone have any ideas how to handle this when it becomes half office and half telehealth clientele?

There is a lot of info out there about Insurance companies waiving deductibles and copays during COVID.  I have not seen any ERAs come thru where the copay/deductibles have been adjusted off.All service dates are still being applied towards copays/deductibles. If this is the case, shouldn't the insurance companies be paying the contract rate in full? Wondering how everyone is handling this....Thanks~Tina

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Thank you

we are a children residential TX facility.  We are about to start billoing for CD Assessments can anybody help me out.  We currently bill 0944/0945 for our services under Revenue code 0944/0945  Would I also use this for the revenue code for CD assessments? can't seem to get any answers

Can someone tell me how often we are required to update signatures regarding billing release and where to find that data?

We are skipping Medicare for an unlicensed therapist, adding a GY modifier, and sending it to MA/PMA. (FIRST, skipping Medicare)  MA/PMAP denying due to billed to wrong insurance (Not Primary). Medicare denies for Unlicensed therapists. Please help me what are we doing incorrectly?