Hello,

I am curious if anyone has taken advantage of the new Minnesota statutes that allow three psychotherapy sessions to be billed before a DA is complete?

My problem I am running in to is what billing code to choose that will be accepted by the state. Since there is no diagnosis yet, staff have been billing Z codes, but I am not sure if psychotherapy will be reimbursed for Z code diagnoses.

Thanks,

Chris

Good morning!  

I have heard from several people that Zoom meeting is HIPAA compliant and insurances cover Zoom sessions.  Does anyone know if this is accurate and how to go about billing for these sessions?

Thanks & have a great week!

Jill

If you have a client whose secondary payer allows more than the primary payer and the secondary processes the claim by paying whatever the CCD was from primary but still owing CCD, do you charge the client or adjust it off, since the secondary covered a minimum of the CCD from primary? Ie. primary Health Partners has a lower allowed amount for a certain code than secondary BCBS. HP has a $25 co pay. BCBS pays the co pay, sometimes more, but then is also processing the claim with CCD up to the BCBS allowed amount (which in this case is pretty decent amount). Do you charge the client the difference or adjust it off since you were paid by primary and the secondary covered the CCD from primary? Thanks. sorry it's confusing to explain this.

I've been noticing the last few Ucare PMAP ERA's have been denying every claim with a "UA" modifier. Is it something I'm doing wrong, or is it an issue with UCare? Anyone else been having these issues?

Hello! So, I had a patient call regarding Medicare denying our ARMHS code, H2017. She called Medicare and said I submitted it incorrectly. When I called Medicare, they said that the code had an "I" next to it and I'm submitting the wrong code.

Is there an equivalent Medicare approved code that would cover this type of service? Or am I getting mixed answers?

Wondering if something happened because of Christmas, maybe? We usually get around 8 or 9 different remittances from MN-ITS, only got 2 this week. Another organization I contract with also did not get the remittance from MN-ITS through Procentive, either.

This is an important notice specifically for providers who serve patients with TriCare. As you may have heard, TriCare is changing effective Jan 1, 2018.

What does this mean for you and what you do? In order to continue receiving payments from TriCare, the Procentive Customer Care team has identified steps that are important for your organization to complete before January 1, 2018. The exact steps depend on which TriCare Region you bill to. Please be aware you may need to make changes to more than one region.

If you bill to TriCare West:
(Procentive is switching clearinghouses for this payer)

• To start/continue receiving ERAs (electronic remittance advice) into Procentive for TriCare West, please complete this form and fax to TriCare (attn: T2017 West EFT/ERA) at (1-888-282-2841).
• Send the form to Procentive via fax (1-888-354-9053) or upload in a Support Ticket.
• To receive or continue to receive EFTs (electronic funds transfer) from this payer complete the EFT paperwork again.
• Verify with TriCare that you are still credentialed with the correct claims processor. If you are not certain who your claims processor is, please call your Provider Representative at TriCare.

If you bill to TriCare North and/or TriCare South:
(They are merging to become TriCare East)

• To continue submitting claims and receiving payment, enroll for claims submission, ERA and/or EFT by completing the instructions within this document.
• Once the enrollment steps are complete, then notify Procentive (via a Support Ticket). This step is necessary so that Procentive can complete the process on your behalf.
• Verify with TriCare that you are still credentialed with the correct claims processor. If you are not certain who your claims processor is, please call your Provider Representative at TriCare.

Please don't hesitate to contact the Customer Care Team via a Procentive Support Ticket if you have questions.

Is there a Procentive feature that prevents services from being billed before the DA is complete? 

Is it possible to schedule for a PMAP to become inactive at a certain date?  We have a client who has BCBS PMAP through November, but is on straight MA as of 12/01/2017.  We have several service lines to bill in November yet, which will be processed next week.

Since the new payer has been activated for 12/01/2017, is there a setting where I can tell Procentive to deactivate BCBS on 11/30/17 and have MA become active 12/01/2017?  I'm just thinking that this would help eliminate rejected claims by associating new claims to an old payer.

I'm hoping this makes some sense...