I have noticed in the last couple of months that the out of state BCBS policies are denying the travel code (H0046) as CO instead of PR which is also causing a denial from the secondary.  What have others done as a work around to this?  

Is anyone using G-codes and other tracking codes for quality measures and reporting them to the insurance plans? 

If so, are all payers allowing them to process through their systems, such as Commercial plans, MA/PMAP plans, and Medicare?  Or are they rejecting the claims because of these codes?

We are going to be using some that will be tracking BMI (G8417, G8418, G8420, G8422, G8938, G8421 and G8419), Tobacco screening (4004F, 10036F, 4004F 1P, 4004F 8P), Alcohol (G9621, G9622, G9632, G9624) Suicide risk (G8932, G8933), Screening for clinical depression (G8431. G8510, G8433, G8940, G8432, G8511), and PHQ9 (G9511, G9509 and G9510).  Wondering if anyone else has any experience with these codes.

Thank you!

I have noticed that, besides UBH, the payout difference on a 90791 and a 90837 is only a few dollars. Have others noticed this? Should I be negotiating a higher payout on 90791s?

More information here

When I resend the claim, it does not bring the claim up for me to check and send electronically.

Nothing is there.

Good afternoon! We have therapists that see clients at a Twin Cities juvenile detention center. We would like to bill travel - which location code is best to use in this case?

Thanks & have a great day!
Jill

Is anyone else having an issue with denied claims from Medica UBH when selecting LOA days on claims?

Good afternoon,

This afternoon I received a remit from UBH PMAP taking back payments as far back as February 2016. I called UBH to inquire the issue. They advised they "just found out" the client had primary insurance, BCBS. My response was, we are beyond timely filing to bill the primary insurance. UBH left us with no recourse or options to bill DOS from February 2016 to May 2016 due to timely filing. I then asked for the Appeals Dept.

My question to the community - What is your success going to the Appeals Dept with this kind of case? Can anyone provide insights to insurance payers having the ability of going this far back recouping payments because "they just found." Shouldn't payers have a timely response to these kinds of events vs recouping payments beyond one year after the fact? Thank you all for your time.