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MA pay to provider denials

Has anyone had any issues with MA and their billing location NPI dropping off claims and then MA denying? the NPI for the specific service provider locations seem to be dropping off the claims, resulting in multiple denials that we are manually fixing in MN-its.

Any feedback would be helpful. Thank you

We have put a ticket, but just aren't having any luck. Also have tired calling the state and there is no internal issues on their end. 

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Getting copies of ID cards DL

Kim Ross 5 years ago in Billing/Electronic Modules updated by Bobbi 5 years ago 2
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BCBS MN telehealth claims

Ashley 5 years ago in Billing/Electronic Modules updated 5 years ago 3

Has anyone else been having trouble with BCBS MN telehealth claims?  I'm having trouble billing our outpatient CD groups for telehealth.  I'm billing H2035 HQ with rev codes 0944 or 0945, no modifier and POS 02.  I've also tried billing with a modifier of 95.  I continue to get rejections with the following message:  "Error Message: Category: Acknowledgement/Rejected for relational field in error.  Status: Claim submitted to incorrect payer Entity: Billing Provider"

I'm unsure what to do or what to change as my Blue Plus claims are going through correctly at this point for the same provider and codes.

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GY modifier order

Scott VanBerkom 5 years ago in Billing/Electronic Modules updated by Anissa Jones 5 years ago 1


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When billing with a GY modifier, is there an order in which the GY needs to be listed in when billing multiple modifiers?  

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Associate Billing Code to Specific Programs

Jonathan Beulke 5 years ago in Billing/Electronic Modules updated 5 years ago 2

Does anyone know if I can/how I can associate a billing code for a specific program within Procentive?  For example, when our LADCs create a service line, I only want them to be able to see the billing codes specific to 245G, not codes for our residential and mental health clinic programs.

I tried figuring this out on my own, but have not been able to find something that may work for what I need.

Thanks

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workers comp and auto-related claims

Kim Ross 5 years ago in Billing/Electronic Modules updated by Mark Cornell 5 years ago 7
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Bill multiple codes

Laura G 5 years ago in Billing/Electronic Modules updated by Sheryl Martin 5 years ago 3

We billed an H0032, 90791, 90834, and Ucare paid the H0032 and the 90791 rejected the 90834. If I do a replacement claim what code or codes should get the 59 modifiers as an add on?

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I have a question. When billing the S9480 code is it a one time per diem rate or must you have skills and group therapy to bill this code

TVano 5 years ago in Billing/Electronic Modules 0

When using the H2012 (bundled code) there must be a group therapy and at least 4 units of skills. Is this also true for the S9480 code for commercial? Or can you bill S9480 with just skills and no group therapy 

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Policy ID 9-11 Digit Fix

Scott VanBerkom 5 years ago in Billing/Electronic Modules updated by LaVonne James 5 years ago 1
Running into this issue when billing : ID number is however correct. Unsure how to bypass this error to push the claim for this client. 

(The individual policy id must be between a 9 and 11 digit number(no dashes)) 
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Telehealth reimbursement for CTSS and H2027?

Kim Ross 5 years ago in Billing/Electronic Modules updated 5 years ago 1