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MHCP Provider manual requirement for DA date of service

Kim Ross 7 років тому в Billing/Electronic Modules оновлено Chris 7 років тому 1

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

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

ppatche 7 років тому в Billing/Electronic Modules оновлено Susan Davis LICSW 7 років тому 1

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?

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Has anyone billed for injections of medication? I believe the code is 96372.

Shondell 7 років тому в Billing/Electronic Modules оновлено LWright 7 років тому 1

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.

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Has anyone obtained a letter from Medicare that says Medicare will not reimburse a provider or providers because of licensure?

Kim Ross 7 років тому в Billing/Electronic Modules оновлено Mark Cornell 5 років тому 7

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

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Billing 96101

Candace 7 років тому в Billing/Electronic Modules 0

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. 

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Sending claims to secondary if there is no CCD left for secondary to pay

crystalp 7 років тому в Billing/Electronic Modules 0

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)?

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Є відповідь

Issues with slowness and modules not working.

Shondell 7 років тому в Billing/Electronic Modules оновлено anonymous 7 років тому 9

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.

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Psychotherapy before DA

Christopher Burt 7 років тому в Billing/Electronic Modules оновлено Chris 7 років тому 13

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

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Zoom Meetings

Jill 7 років тому в Billing/Electronic Modules оновлено Richard Sethre, Psy D , L P. 7 років тому 21

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

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Two payers and secondary payer has higher allowed amount/contracted rate than primary.

crystalp 7 років тому в Billing/Electronic Modules оновлено Shauna Dall 7 років тому 8

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.