We have a nurse practitioner  who is newly licensed and is getting started on the credentialing process.   Has anyone billed under a NP supervisor while waiting for credentialing to go through using the modifiers GC or GE?   She would like to see clients while waiting for the credentialing to be completed.  Thanks. 

Is anyone else having problems in the Billing Module?

Can anyone tell me if you can bill a 90785 with a S5145?

Thank you

I am just wondering if anyone is experiencing issues with Blue Plus CTSS claims  getting denied saying  that you need a prior authorization. We starting having issues with claims on 5/18/23 to current. 

Need help troubleshooting a clearinghouse rejection. Randomly, there is a 3 week period in which a large portion of my OP SUD Ucare PMAP claims are getting rejected citing   ":ENTITY'S SPECIALTY CODE, ENTITY'S SPECIALTY, TAXONOMY C
ODE.:ATTENDING PHYSICIAN"

I cannot figure out where this is stemming from. Nothing has changed w/our clinicians, billing, coding etc and the taxonomy code is the same as it has been. Strangely, this was only an issue for a few weeks in April.  Did anyone else have this issue?  Solutions?

Does anyone bill SUD to UHC? Are you getting payment? We were told that UHC doesn't allow the H2035 code. Our claims are all denying for needing a PA or rendering provider is not eligible to perform the service. When calling UHC to verify coverage, we are told no PA needed.

We provide Chemical Dependency & Mental Health for levels of care of PHP, & IOP.  We have been having issues with BCBS ND Medicaid Expansion paying on our claims, only to come back now and take the money back from us.  When I called to ask why they took the money back from us, they keep telling me its because of an invalid Type of Bill and Status.   They keep telling me that its coming through as 1-Admit to Discharge, so to look at AMA Correct Coding Guidelines and resubmit once we figured out how it should be billed.   That's where I am lost. 

We bill using UB04 claims for most of these services.  In the admissions tab we use with a 13-Hospital Outpatient and put in the client's Admit Date & Time and put the Status as 30-Still Patient.  We file this these options with all of our claims.  Once the client discharges, then we will go in and put the Date & Time and then change the Status to the appropriate Discharge status.  

Any ideas as to what they are meaning with 1-Admit to Discharge and what it is we may need to change in Procentive to get our claims to go through properly.  We have billing the above way for over 10 years now and have never had this type of issue before and so far it is only with BCBS ND Medicaid Expansion claims and so far only on just random dates of service have they taken their money back from us on. 

Any help is greatly appreciated!

Does anyone know if you are able to export a billed invoice to Excel in order to edit?

Thanks!

Hello, are there any organizations that are currently billing the codes S0280 and S0281 for behavorial health homes. We are wondering how these get billed out of Procentive? Do you just create an individual session once a month to bill this or do you bill off of a residential calendar? Any other pointers you can give us?

Has anyone else experienced problems when billing the 99354 add-on code for an extended session for 2023 DOS? Claims are rejecting in the Electronic Module. This was a BCBS commercial policy.

Stating the following:

Error Message: Category: Acknowledgement/Returned as unprocessable claim-The claim/encounter has been rejected and has not been entered into the adjudication system. Status: Line information

Error Message: Category: Acknowledgement / Rejected for relational field in error. Status: Procedure code for services rendered

Error Message: Category: Acknowledgement / Rejected for relational field in error. Status: Date(s) of service

Error Message: Service Line Data: SVC*HC:99354*120*****1~Version: 5010A1 Loop: NA

Thanks, Sara