Is anyone else having issues with workflow with the interaction types that you use? We have multiple programs so how I have it set up is I have a project for tx plans but for each program. for example I have a tx plan for ARMHS and MH I then set each of them up with their own workflow project by program and they each have their own interaction type for that program. However when I change one it changes the other to what I just updated let's say Mental Health. I am getting really annoyed. I did not even copy one from the other and they are different tx plans as well. Anyone else notice this? 

thank you 

Teresa with North Homes Children and Family Services 

We keep getting rejects with the following wording, wondering what others have done because it seems to stop them from ever getting to the payer, but doesnt really say whats wrong?

 Category: Acknowledgement/Returned as unprocessable claim  The Cl
aim/Encounter has been rejected and has not been entered into the adjudication system St
atus: Processed according to contract provisions (Contract refers to provisions that exi
st between the Health Plan and a Provider of Health Care Services)

Good Morning Community,

I've recently run into remits in the Pro-ERA Module where the insurance payer will not pay anything on the DOS and will filter the allowed amount to 187, which is a health savings account designation. 

How do you manage this? Do we wait for the HSA pmt to come in? Any support is appreciated. Thank you in advance. 

Debbie

Good Morning,

Recently we've been noticing some service lines being sent to the payer without an audit ready note, or no note at all. Is this a glitch in procentive or are we doing something wrong? It seems to happen randomly. Any ideas on how to make sure that this doesn't happen? We are newer to this system so any "easy" walkthrough answers are appreciated.

Thank you!

Does anybody use Procentive to track clients needing to be scheduled for intakes?  If so how do you do it?

Hello -

As it is so difficult to get someone on the phon at Medicare, I thought I would post here to see if anyone else has experienced this issue.  We have had issues with billing for substance use disorder services in the last few months with PMAP policies that are secondary to Medicare.  What most recently happended is that the client didn't inform us of a primary Medicare policy, and we found out about it after getting claim denials from the secondary BCBS MN PMAP policy.

Here is the issue:  our facility and providers are not Medicare eligible - in fact in the past Medicare has told us that we cannot send claims to them; Medicare stated that patients would need pay us directly for services, and then send claims to Medicare themselves in order to get reimursed.

I'm at a loss at this point as to how to proceed with secondary claims to BCBS MN - I can't get a denial as I can't send claims, and BCBS MN won't pay without COB information.  

Any advice?!

Currently setting up Procentive and am wondering how add on codes work in the system.  Example the add on code for interactive complexity (90785) or travel code (H0046).  Have tried to send a few codes through by using the override overlap button in the Time Module on both the service line and the add on line but when I get to the billing module I get an error that the add on codes are not attached to a service line and cannot be billed electronically. Is there a better way to do this?

UHC has found an issue that is causing some ERAs from check date 09/27/2017 and forward from being sent. This applies to the following payers and IDs:

• AARP Insured By UnitedHealthcare Insurance Company ID 36273
• UnitedHealthcare ID 87726
• UnitedHealthcare Community Plan WI ID WID01
• UnitedHealthOne All Savers Insurance (AMS) ID 81400

We will update this post once we've received confirmation that this is resolved. 

Thank you!

Hello, I am wondering if anyone is open to sharing how they document on Quickbooks? 

I am realizing when I enter and invoice. Get a rejection. Then change the invoice date to reflect when we resent that claim - my books are not reflecting accurately. 

I could show I billed out $10,000 to for someone in September.

Get rejected.

Edit those invoices for October. 

So for our board of directors the original September totals would look different after I did that. 

Any input would be great ! Thank you! 

Hello!

I have an ERA  that shows no amount paid, but when I open the claim, it was that $41.60 is paid. I have the blue dotted box with multiple listings in it...for example:

WO>20170405 PR(Claim number here)   $Amount

I know sometimes these are used for interest, but what does the WO mean and how can I pay the claim without having this ERA overallocated?