Is anyone else having any issues running eligibility?  When we run ours thru the module and refresh when complete, everyone of the clients is coming back marked as "active" when they are not eligible.  And on the other spectrum, ones that are truly active are coming back as "inactive"  

We have started a ticket, hopefully this will resolve ASAP as tomorrow is the first and the vast majority of our clients are MA/PMAP clients.

Has anyone had any luck billing UA's/drug screens to BCBS of MN?  We have quite a few clients w/BCBSMN PMAP policies, and we are writing off a lot in drug screens for clients.  Any ideas/codes/experience would be appreciated!

Does anyone have a procedure in place when a licensed clinician gets married/divorced and has a name change? Do you bill under both names until the change is complete with all payers?

Good Day!

The MN DHS Provider manual says the following about billing diagnostic assessments: 

- Complete all Diagnostic Assessment (DA) Report Components before billing a DA
- Enter the date of service for the DA as the date the written DA report is completed

We have always used the face-to-face date as the DOS to bill a DA, and are billing after the DA is marked audit ready (completed). The State of MN, however has advised us to bill the date of service as the date the DA report is completed. (This is documented by the MHCP provider manual and via email correspondence we have received. I have also heard this said by DHS staff directly!)

I realize that agencies who use Procentive do both -- that is bill with the DOS as the face-to-face date or bill the date of service with the date the DA is completed.

If you use the DA completion date as the DOS -- a couple of questions:

How is it working / what is your process?

Do you do the same for all payers: MA & Private?

Thank you!
Kim

Has anyone been receiving calls from UBH/OPTUM saying that clinical trainees cannot provide  Mental Health services even if they are clinically supervised by a credentialed/licensed LMFT?

We have never billed for this service.  Everything I read says that I need to put the medication information on the claim.  I'm wondering if anyone has worked with this before.

We have a case where Americas PPO (Mayo Health Solutions) will not pay our claims unless we either send a Medicare EOB or a letter from Medicare to substantiate that the services is not reimbursed by Medicare. Because these types of claims don't get processed by Medicare b/c the provider is not in network, we don't get an EOB. How are we able to get a Medicare letter documenting provider ineligibility for Medicare reimbursement?  

Thanks so much!

Kim

I am reaching out to the community to see if anyone has experience with billing 96101 codes as a Clinical Trainee or predoctoral intern? I have my Master's degree in Applied Psychology, which qualifies me to do psychological testing. I also have nearly completed my 2,000 hours internship requirement toward my PhD in Clinical Psychology (all necessary coursework is completed). I still will be working on my dissertation however. At the conclusion of my internship, will I still be able to bill 96101 under the supervision of a licensed psychologist for private insurance? If an organization has any input, it would be greatly appreciated. 

I recently read something in one of the payer manuals that said they still want claims sent to them if they are the secondary payer even if we know they would not pay because there was no CCD left from primary payer. What is your billing practice? If there is no CCD or PR left from how the primary payer processed and paid do you still submit claims to the secondary (whether its commercial or MA)?