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Telehealth - Mod 95 when Billing CCDTF/R25

Jeremy Roelofs-Lynch 5 years ago in Billing/Electronic Modules updated by ahuseby 5 years ago 2

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

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Health Partners (HP PMAP) Comprehensive Assessment Billing?

Jeremy Roelofs-Lynch 5 years ago in Billing/Electronic Modules updated by Teri 5 years ago 3

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

Jeremy

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What to do when clients are being seen in the office and via telehealth

Tina B 5 years ago in Billing/Electronic Modules updated by Rochelle Garcia 5 years ago 1

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?





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Waiving deductibles and copays during COVID

Tina B 5 years ago in Billing/Electronic Modules updated by Susan Davis LICSW 5 years ago 1

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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Known Issue

Please see our Live Updates page regarding an intermittent issue that could have occurred regarding Audit Ready service lines.

Thank you

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Billing for CD assessments.

Mary Lou Meyer-Rolfe 5 years ago in Billing/Electronic Modules updated by Carolyn Bunker 5 years ago 1

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

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Release signed by client of medical billing data related to claim:

sfoster 5 years ago in Billing/Electronic Modules 0

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

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GY Modifier

Laura G 5 years ago in Billing/Electronic Modules updated by akeller 5 years ago 1

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?

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Place of Service Denials w/ Commercial Ins.

Scott VanBerkom 5 years ago in Billing/Electronic Modules updated by sarah 5 years ago 3

Anyone have an idea if Health Partners or (Any other commercial plans) Deny payment based on place of service (Anything other than Office or Telehealth) This one in question pertains to "School" as the place of service, the therapist is the treating provider. 

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Denial code 4.

Laura G 5 years ago in Billing/Electronic Modules 0

Does anyone know what is wrong when billing a 90837 and a 90899 I keep getting the denial code of 4. The 90899 was billed with the U9 and U4 modifier. Thanks