Does anyone have any input on codes; 99050 or 99051? These are "after hours" billing codes, from what I understand. 

Thanks, Sara

KNOWN ISSUE:

Some claims submitted to SCHA Payer ID 81600 and MMSI Payer ID 41154 through Claim Lynx are returning with an Error Status since 12/04/2018.

Claim Lynx has informed Procentive that this is an error with the Payers.  They are evaluating this issue and working towards a fix by end of day 12/07/2018.

According to Claim Lynx if you have received the status of error, you do not have to resend your claims.  The claims have been received by Claim Lynx and will be processed by the payer once this issue is resolved.

If you have further questions please contact Procentive Customer Care via ticket.

I have inherited a problem with BCBS commercial plans when billing 1002 and H2036 HA, HH. We bill multiple units for each and on a invoice I have noticed that they are reimbursing as for the Room and Board however they are NOT reimbursing us correctly for treatment services.  When I called BCBS they stated this was because of a date range issue however I have been told by Procentive that is not accurate and that I need to remove the HCPCS code from the claim.  

Does this sound familiar to anyone? what do you do to get your claims paid?  I have noticed that we have been taking LARGE adjustments on H2036 and would greatly appreciate hearing what worked for you to get your claims paid.  

Our facility has never billed secondary payers. I am trying to get this set up but seem to be struggling.

Can anyone share best practices, tips/tricks, workflows, lessons learned...?

Do you bill the secondary when you are posting the ERA/Payment via the ERA Module?

Do you do everything manual in the COB Tab?

Is anyone currently billing or had any success in billing for assessments such as the PHQ, GAD, etc?

This is a sticky situation, but does this happen to any other agency, and how do you direct/navigate the guarantor to resolve these issues?

Client is a minor whose primary insurance is through biological father, secondary insurance is through MN Medical Assistance.  The primary insurance through biological father lapsed, and we’re told there is no way to contact biological father to verify primary benefits or inquire.  If we send the claim to MN Medical Assistance, they will deny because they have biological father’s insurance on file as a Primary.  Feels like we are stuck.  How do you get the wheels moving forward on this?

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)

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