Hi all, Not sure I'm posting this in the correct forum. I'm looking for some information about coding for interactive complexity for clinicians doing play therapy. When adding this to 90837 or similar service line, do other clinicians typically record notes for both service lines or is a note for only one (or the other sufficient)? Our interactive complexity codes got denied and they were added at the same time as the main service code but notes were only included with the 90837 line so wondering if that was the problem. Any help with this would be welcome.

I'm fairly new to Procentive, so this subject may have been covered...

I got a calim back from UCare. It has takebacks which are fine...after processing almost everything in the claim, I'm still 2.77 short for a payment on a claim. That amount is in the left hand corner of the ERA in a blue dotted box  that says:

Date              Code        Adjustment

12/31/2017    L6:IX        2.77

Is that available to use? If so, how do I process it? I found information on the Procentive Knowledge Hub about interest payments, but that doesn't seem correct.

TIA!

How many of you find it difficult to work with the BCBS Affiliates and their Blue Card Program.  It seems our experience goes one of 2 ways...either the UM/claims go through without an issue or we have nothing but an issue out of the gate (often it revolves around coding...specifically the H205 (HQ).  The struggle is they want us to bill a per deim code when statutorily the H2035 is all that is available.  It is when we have an issue that rarely is it fully resolved.  Currently we have 3 active claim issues one dating back to 2015.  BCBS-MN seems to give it a half hearted attempt to resolve.

Recently for Blue Plus when billing out individual lines of 96101 they will pay on one line and deny the others saying it is duplicate.  I was told that I now have to use a modifier to bill these out? What modifier should I use? I am only having this issue recently with Blue Plus. 

Does anyone else bill BCBS for substance abuse? We are constantly getting rejections by BCBS, and the status is always vague:

Error Message:         Category: Acknowledgement/Rejected for Missing Information  The C
laim/Encounter is missing information specified in the Status details and has been rejec
ted Status: Information submitted inconsistent with billing guidelines. Note: At least o
ne other status code is required to identify the inconsistent information.

This happens to probably 75% of the claims I bill out, and I can't seem to pinpoint why...

Medica and MHCP are no longer accepting the GY modifier, they state that they have to have the primary EOB, but we can't send claims to Medicare if the provider is not in network, meaning we can't send the EOB. Ideas, thoughts?

Is there a way to get COB information to flow over for manually entered claims instead of going into the COB tab and entering them yourself. This is the first billing system I have used that required it to be manually entered like this even with hand entering the payment.

Good morning!

Therapists with our agency will often do skills based services in the community.  This can occur in a variety of settings which may include restaurants, schools, library, etc.  What is the appropriate place of service to bill in this instance?

Thanks & have a great day!

Jill

Every client I try to send claims for today I get the error, The client address must not be empty or have spaces before or after. However there is nothing wrong, anyone else having this?

Does anyone know if Commercial insurance plans only allow a certain number of Diagnostic Assessments to be billed to them in a year?