Heads upUCare for Seniors 2017
As of this year there is a new requirement for outpatient counseling for UCare for Seniors clients. A prior auth is required for anything other than an intake. This caught us by surprise and the provider newsletter it was featured in was very obscure.
med management denials with Aetna
Has anyone else experienced consistent denials with Aetna for med mgt codes: ie 99213, 99214, & 99215 for various reasons including no authorization, no referral or provider type cannot bill this procedure? Every time we call to see exactly why it denied, we get different answers. I've spend 1 hour today, trying to get to the bottom of it and I still don't know if I'm clear with what we need. Some reps say the plan needs a PCP referral, another rep says we need pre-auth, pre-cert dept says it's not needed for mental health, some say add modifier 25, etc... help!
How do you/can you bill for 2 hours of therapy by the same provider?
How would you bill a 2 hour session with one provider and then bill another hour of resourcing with a different provider?
Coding specialists? Code stacking and modifier 59.
Has anyone in this community taken a coding class or have coders/billers who are well educated in the area of code stacking/billing multiple codes for one DOS with same provider? We have providers who render in home services that last longer than 1 hour and are trying to teach them how to code stack and then trying to figure out the best way to bill them to get them paid. Any help is appreciated!
Billing for tx plans
Has anyone started billing for CTSS tx plans, and if so, are MA and PMAPS paying for them?
Anyone else having BCBS Illinois denials for LMFT ?
At this time I'm just wondering if anyone is having these denials. We may be asking for help!
Our scenario: Starting in August, after BCBS MN had an update to provider types, we got denials for clients who see our LMFTs and have a BCBS IL plan through their employer. We have started an appeal process over these denials. Now BCBS IL has recouped payments made from Jan to July; we've included a request for re-payment in our appeal.
Thanks, Kay
Group psychotherapy advice?
We are looking at billing for group psychotherapy for the first time, specifically Therapeutic Yoga. Any advice or guidance? Looks like code 90853? What about reimbursements, time? Thanks!
Skip Billing Primary Payer
When billing clients that have MA or PMAPs, is there a way in procentive to skip billing Primary once they deny CTSS services?
Customer support service by UserEcho
