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Bypassing Primary Payer when Billing Option(s)?

Jeremy Roelofs-Lynch 6 лет назад в Billing/Electronic Modules обновлен Kim N 6 лет назад 3

Does anyone know if it is possible to bypass a primary payer that does not except our codes when the client has a secondary payer that does except them? I.e. Modifier? 

NOTE - primary is NOT Medicare or a Medicare Product. (We use GY)

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Rejections- Private BCBS

jparker 6 лет назад в Billing/Electronic Modules обновлен 6 лет назад 2

We are new to Procentive and I have a couple issues I could use help with. The first one is I am having trouble with rejections from Hennepin Health ,first on was about service codes fixed that resubmitted now the rejection is "service line days" looked at the X-12 summery and claims looked good! Anyone have any insight? Next pertains to BCBS Private claim we as a company do 96% consolidated and Pmaps, when I submitted BCBS paid one day on both claims called them and they said for Private I should not send HPCS  or modifers on a Private claim. does not seem correct to me. Would appreciate any help

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We are new to procentive and I have two issues....

jparker 6 лет назад в Billing/Electronic Modules обновлен crystalp 6 лет назад 1

We are new to procentive and I have two issues. First I am having trouble getting clients with Hennepin Health out of the module had an rejections on Unit codes fixed that now they rejected because of "service line days" looked on the X-12 summery and claims looked good. Any insight out there? Second issue is I cannot get a Private BCBS claim to pay at our private rate,called BCBS and they said that I cannot put HPCS codes and modifiers on a Private claim only on a Pmap,does not seem correct to me.95% of our clients are consolidated or Pmap so this does not come up often. I greatly appreciate any help.

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Has any clinic ever billed Intensive Outpatient Program IOP to Medicare, if so what code?

Kelli Feucht- ACS 7 лет назад в Billing/Electronic Modules обновлен Susan Davis LICSW 7 лет назад 1

We are wondering if any clinic has ever billed Medicare IOP(Intensive Outpatient Program) services, if so what code?  Any information would be helpful.

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Referring Provider on an 1500 Professional Claim

Jeremy Roelofs-Lynch 7 лет назад в Billing/Electronic Modules обновлен 7 лет назад 2

We are attempting to bill an IFB (Individual & Family Business) plan that requires the referring provider on the claim. I am having trouble getting this populated. 

Where is this pulled from in Procentive?

Any help is appreciated! 

JRL

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Becoming a Medicare Provider

Diane Bilger 7 лет назад в Billing/Electronic Modules обновлен 7 лет назад 4

How involved in the Medicare application process?  Our agency is not currently set up as a Medicare provider, but need to move forward on applying.  I'd appreciate your thoughts on how time-consuming the application process is from start to finish.  

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Anyone have any luck billing any of the various 90899 codes to Medicare?

sfoster 7 лет назад в Billing/Electronic Modules 0

Anyone have any luck billing any of the various 90899 codes to Medicare?

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Electronic Billing of CHAMPVA

Vicki/Billing 7 лет назад в Billing/Electronic Modules обновлен 7 лет назад 7

Does anyone bill their claims electronically to CHAMPVA?  We tried years ago but were told that the claims must have the licensure of the therapist on them (Since they don't credential).  Paper claims take forever to process.  Thanks

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Has anyone billed 96101 GY to BCBS MN?

John-Debbie Trunk 7 лет назад в Billing/Electronic Modules 0

I have a MA, LP who has an intake that has Medicare as primary insurance and BCBS as their secondary plan. The rendering provider did not renew his contract with Medicare. I'd like to know if anyone has billed 96101 GY to BCBS successfully? Thank you.

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Coding Question

Jill 7 лет назад в Billing/Electronic Modules обновлен 7 лет назад 2

I am looking for some advice in coding an individual therapy session that lasted for 2 hours.  I believe the 90837 is for 60-90 minute sessions, correct?  I appreciate any assistance you can provide!

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