Hello, 

I am getting a rejection from SCHA for a chemical health assessment (H001 0900) for just one client stating:

Category: Acknowledgement/Rejected for Invalid Information - The claim/encounter has invalid information as specified in the Status details and has been rejected. Status: Claim/submission format is invalid

Category: Acknowledgement/Rejected for Invalid Information - The claim/encounter has invalid information as specified in the Status details and has been rejected. Status: HCPCS

Category: Acknowledgement/Rejected for Invalid Information - The claim/encounter has invalid information as specified in the Status details and has been rejected. Status: Date(s) of service

I have verified eligibility for the date of service.

I opened a ticket with Procentive and they are saying that I need to send the claim as a Professional claim but we have ALWAYS billed as institutional without errors. I am SO confused and frustrated. Has any other CD billers ran into this issue with SCHA? Was there an update I missed regarding SCHA not accepting assessments as institutional claims? 

Thanks, 

Katie 

When billing Professional claims (Institutional box unchecked in "Create New Invoices"), we frequently get the message "A supervisor with a valid NPI is required."  Is this a setting in Procentive that triggers the notification or just a default of Professional billing?  If it's a setting, where is it found?

Is anyone else noticing a huge influx of rejections within the Electronics module? We would rarely get rejections and now it seems like I can hardly keep up and I have no idea what the issues are. I understand the issue with Blue Plus does not help but I am also seeing other payers rejecting and I'm wondering if there is an issue within Availity? I have created tickets for help but that seems to be taking foreverrrrrr. Example of a rejection - billing UMR for a client we have received payments previously and it appears most of the client claims are being accepted but a couple random ones are rejecting stating  "Acknowledgement/Returned as unprocessable claim-The claim/encounter has been rejected and has not been entered into the adjudication system. Status: Subscriber and policy number/contract number not found." Just feels like i'm going in circles in the electronics module.... Can anyone relate? Or help?? 

My password has been rest 3 times and I could not get into Procentive with either.

I do nto know hwat category to put this in.

We are trying to confirm which commercial health plans allow clinical trainees (incident to billing).  We've confirmed that most BCBS commercial plans and all Pref One plans allow it.  Has anyone had success with Healthpartners-commercial?  I can't get a confirmation from that insurance network.  We are billing Hpart-PMAP without any issues.  Any current information for clinical trainees would be appreciated.  Thank you.

Is there a way to create 1 statement for multiple families?  So if there is a parent and 2 kids receiving services, we can send one bill to the family as a whole versus separate bill for each family

We have a nurse practitioner  who is newly licensed and is getting started on the credentialing process.   Has anyone billed under a NP supervisor while waiting for credentialing to go through using the modifiers GC or GE?   She would like to see clients while waiting for the credentialing to be completed.  Thanks. 

Is anyone else having problems in the Billing Module?

Can anyone tell me if you can bill a 90785 with a S5145?

Thank you

I am just wondering if anyone is experiencing issues with Blue Plus CTSS claims  getting denied saying  that you need a prior authorization. We starting having issues with claims on 5/18/23 to current.