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)?

I know people are having problems with the eligibility module, but is anyone having issues with every module?  My billing module isn't working.  I am getting complaints from staff that the clinical module is having problems.  This is the big day of the month to do facility billing and we are stuck.

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?