Hi Community,

I'm hoping someone out in the community has an answer to this question.

If an ARMHS client has Medicare as their primary insurance payer and PMAP/MA as their secondary payer and is seeing a NON-Medicare provider, how to we bypass Medicare and bill the PMAP plan or the MA plan as the primary insurance plan? Do we need a modifier to do so?If a modifier is required, what is the modifier code used bypassing Medicare, billing PMAP/MA as the primary payer.

I'm advised we should bill Medicare first and get the denial then send the claim to the secondary plan, PMAP/MA.

Does anyone have experience with this? I'd love to hear from someone. Thank you for your time.

We have a therapist who wants to provide Exposure Therapy but we've never billed this before. Are there any pitfalls, tricks or do you find insurances won't pay for it?

Also, she wants 1-1/2 hour sessions - since there's not a code for this unless it's a crisis what code(s) work?

Thanks - any assistance would be appreciated! Kay

We're newly CTSS certified and trying to determine how to use the UA modifier on under 18 clients who have MA/MAPMAP's. For those of you already CTSS certified, if you have the UA modifier set to attach automatically when you select CTSS in the client/payer/enrollment module, does it attach for ALL services and get reimbursed? When did you begin using the UA modifier?

Is anyone Billing Crisis Services for Mobile Crisis Outreach (MCO) Services to Commercial Insurance? If so, what codes are you using to bill and which insurance companies are paying?

Thanks!

For those of you who are billing Telemedicine...what POS do you use when sending in claims?

Does anyone have experience with adding modifiers, such as 59, 77 or 78 when you need to bill two codes, such as 90837 and 90847? Is it possible to bill more than 2 codes on the same day and be reimbursed?

Does anyone have a county contract for SFT? How are you billing and what codes are you using? I have a couple examples, but would like to compare... Thanks so much!

Is anyone using Place of Service 53 (Community Mental Health Center) when billing? If so, what are you doing with the upcoming changes Blue Cross Blue Shield is making to this Place of Service? Or has anyone heard if other payers will be making this change also?

What do you use as the service date to bill a DA? MHCP provider manual says to use the date the DA is completed/signed by the provider as opposed to the date the provider sees the client face to face.