When using the H2012 (bundled code) there must be a group therapy and at least 4 units of skills. Is this also true for the S9480 code for commercial? Or can you bill S9480 with just skills and no group therapy 

Insurance termed so I posted the takeback to the clients account. What exactly are the next steps that I need to do so I can rebill this to secondary ins for the full amount of the claim??? 

Buckle up, this is a deep dive.

To understand the nature of the question, it is important to first understand that when my organization sends claims, each day usually has more than one service line for the same code, because clients attend more than one "group" in one day and the services are billed separately. So as a result, we have multiple service lines, for the same client, on the same day, with the same code.

When posting payments, my organization requires payments to be applied in proportion to the number of units to which that payment is being applied.

With this in mind, I am trying to find a way to prevent Procentive the following universal problems:

—Automatically adjusting off money that I want to leave as a balance

—Applying co-pays more than once on treatment days where we bill 2 separate "chunks" of time rather than all units on a single service line

—Improperly allocating funds respective to unit counts (This is my biggest issue with procentive overall. see below)

When, for example, the allowed amount (B6) is 50% of what was submitted, The claim is sent as 3 units and 1 unit of the same code, but the remit bundles these into one lump sum for 4 units. So, Procentive will:

-Put all the money on the line with 3 units

-Adjust the remaining balance

-Adjust 100% of the remaining 1 unit. 

In this scenario, I need to manually tab through every field in payment entry mode to ensure that 3/4 of what was paid goes on the line with 3 units, and 1/4 goes to the line with 1 unit. The only time Procentive gets this right is when B6=100% of submitted charges. Adjustments, specifically, are causing the imbalance. 

(Using the "allocate payment" dialog is not a viable solution, it only works when [B6=100%] OR [there is only 1 CAS code AND all claims paid are in a contiguous time span AND only one client account is being paid on the remit.])

I don't know if this is something that can be fixed on the user end (I have tried messing around with the "rules" for the payment entry mode, and while useful for other tasks, I could not solve any of these problems using them, or any other settings within procentive.) This is a major time drain when payment posting, especially when there are copay/coinsurance/deductible involved. To speed things up I usually just apply the copay to one line where possible, but the payment per unit rule is not something I can do differently. 

Am I overlooking something that I could be utilizing? Can systems engineers write new code to address this? Do we need to change our billing process entirely if we want to avoid this problem? I have been trying to find a solution to this for over a year and I am completely stumped.

I know there is a report for exporting emails from the Contacts module but is there a way to export emails in the clients module? We would also like mailing addresses, if possible.

For our clinic's group sessions we have a mixture of clients who pay for services through insurance, and also those who choose to go the private pay route.  From what we can tell within the Appointments module, there isn't a quick "at a glance" way to determine which clients are private pay, and which ones have insurance coverage.  Does anyone know of a setting or something you have done to quickly show which clients are private pay while remaining in the Appointments module?  The primary reason wanting to see this info is when private pay clients check in, they are responsible for making a payment at the time of the appointment.

Has anyone been able to bill the codes 99441, 99442 or 99443 as suggested by DHS?  If so, what rates are you billing out at?  I am unable to locate this information anywhere.  The 99441 is for 5 - 10 minutes of Telephone evaluation, so is this to be considered your DA and can you charge more for that?  The 99442 is for 11 - 20 minutes of medical discussion and 99443 is 21 - 30 minutes of medical discussion.  Nothing for over 30 minutes.  

Is it safe to assume this is for therapists and care for their clients via telephone?  Or are these codes only for medical doctors?  Not finding clear identification for use of these.

https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=DHS-320036

I've been looking at all my different reports for so long I'm starting to go cross-eyed. Does someone know which report to use if we're trying to get a clearer picture of average reimbursement by code, across all payers.

I've found reports that show total reimbursement over a time period but then it doesn't show total billed. I've found total billed/paid but then it doesn't split out by code, etc..  Do I have to take several different reports and combine all the data in order to get this information?

Any help would be appreciated

Anyone else being booted off the system... Is it me or happening globally?

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