Just wanted to give everyone a heads up to check your Blue plus  and Prime West claims prior to sending. Look on the actually HCFA forms once you scrub /check them  --- it is splitting room and board onto an entire different claim as treatment line. 

This is going to cause things to deny and dupes, deny as a whole because they are not in the format BCBS wants and they are picky on their requirement and potentially PW too. 

We have had a crisis ticket in for 2 weeks now with no fix from Procentive and over 200,000 we can't bill for. If yours are doing the same please submit a ticket as well. This is detrimental to businesses and needs to be fixed.

They seem to think its associate it with the value code option being added to the payer, but it doesn't matter if we use the value code or don't use it it will not send combined correctly.  They say they are not abruptly changing anything cause it could cause issues with other claims being sent without the value code. But again.... either way is NOT sending correctly. So something needs to be "tried"

They fixed UCare weeks ago for the same issues. 

I assume we are all having this issue but maybe just not all aware of it yet. 

Comment below if you are too? 

Jenna

Hello- Looking for input or to see if anyone else is having issues? 

UCARE has been processing 2022 Withdrawal Management claims incorrectly.  We received communication that the billing provider address is not contracted for Withdrawal Management.  Technically not wrong- the Line 2010 Billing provider is our main office.  Also on the claim though is line 2310- the service facility location that is contracted.  We are being told that the billing location has to be the service facility location.  The odd thing is that all claims for all payers go out with the same address set up and no issues with other payers, only UCARE.  Another point I do not understand is we offer several different services at several locations and those are processing correctly.

Ucare is telling us that they are not seeing a service location on our claims. They say they have been manually correcting this but will no longer be doing this going forward. The problem is that we can see the service location on our UB-04 forms when we send out a claim. Has anyone else heard of this and how did you correct it?

We are looking into modifying our billing practice to bill three separate groups (same patients in each group) in one day and having difficulty getting paid using code H2035HQ.   Is there a different modifier we shoud be using?  Not sure what we are missing? Please help!

We are revamping our IOP treatment and will be incorporating PRS (H0038 U8) into our treatment plans. 

We have a clinic separate from our SUD Treatment and want to know if we can bill for PRS services when the client is not enrolled in SUD treatment but receiving other services (MH and Suboxone) through our clinic. 

In reading DHS documents it states these services can be provided before, during and after treatment. 

Any insight would be greatly appreciated. 

Thank you! 

Hello,

Our Ucare claims are splitting room and board and treatment apart and we cannot figure out why (also have a crisis ticket in but wanted to ask here ) Has anyone had Procentive system do this and be able to figure out why? 

Auths are in right, all things match as needed ...

Hello, looking for help in billing for a newly licensed LADC. She should be getting her license in June and then begin the process of credentialing w/payers, etc. What codes are used when billing at an outpatient behavioral health facility for a LADC? Thus far the only codes we use are outpatient codes for; LMFT, LISCW, LPC, etc. Any guidance would be greatly appreciated! Thanks, Sara

Is anyone experiencing a significant disruption in the payments for substance use disorder? We would be very interested in comparing notes on the experience.

I am seeing different modifiers pop up on my charges that I haven't seen before. 

Did something change that I'm not aware of?