Good afternoon,

This afternoon I received a remit from UBH PMAP taking back payments as far back as February 2016. I called UBH to inquire the issue. They advised they "just found out" the client had primary insurance, BCBS. My response was, we are beyond timely filing to bill the primary insurance. UBH left us with no recourse or options to bill DOS from February 2016 to May 2016 due to timely filing. I then asked for the Appeals Dept.

My question to the community - What is your success going to the Appeals Dept with this kind of case? Can anyone provide insights to insurance payers having the ability of going this far back recouping payments because "they just found." Shouldn't payers have a timely response to these kinds of events vs recouping payments beyond one year after the fact? Thank you all for your time.

Has anyone had to bill UBH for interpretive services? We have our first client coming in with an interpreter and we need to bill their insurance.UBH was not helpful in what code(s) we should be billing.

Does your clinic charge late fees or interest to clients whose balance goes unpaid after a certain # of days? Do you feel this really helps to get payments sooner? Is it more of a hassle administratively? How do these fees or interest show up in a Procentive statement? Please give me any input on this as our clinic is revisiting this part of our policy. Thanks!

With clinical trainees, is the clinical supervisor (the one who fills the role of CS as defined by MN Statute) often times different than the billing supervisor? If so, what criteria do you use to choose a billing supervisor NPI to travel with the claim.

In the Procentive staff module, there are 2 fields: one for billing super and one for clinical super. In the payer module, there is also a field for billing supervisor which is the NPI that gets billed with a clinical trainee's service lines.

I'd like to hear how agencies are using the Procentive features, and how they decide which NPI to send with the claim.

Thanks!

Kim

Hello. We recently hired an Advanced Practice Psychiatric Nurse Practitioner to our staff and are working on figuring out what rates to bill for her services.

Does anyone currently have a NP and if so what are you billing for an intake (1 hr) session and a follow up/med check session (20 min)??? What rates do you charge for Private Pay sessions?

What Place of Service are providers billing for CTSS? We are co-located in the schools with our own offices seeing clients.

We are billing POS 3-school and are getting some denials from TEAM (BCBS), Cigna and some UBH plans. Are there other POS codes we should use for this?

Thanks!