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Billing Medicare for Substance Use

KELLY PERFETTI 5 years ago in Billing/Electronic Modules updated by Karen P 5 years ago 3

Wondering if any others have billed Medicare for Alcohol screenings and counseling?  If so what codes did you use, I am not see any codes they recognize.

Alcohol misuse screenings & counseling

Medicare Part B (Medical Insurance) covers an alcohol misuse screening once per year if you’re an adult (including pregnant women) who uses alcohol, but you don’t meet the medical criteria for alcohol dependency. If your primary care doctor or other primary care practitioner determines you’re misusing alcohol, you can get up to 4 brief face-to-face counseling sessions per year (if you’re competent and alert during counseling).

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ERA- Loading Time

Valerie McNamara 5 years ago in Payments/ERA Modules updated by Laura Hulsey 5 years ago 1

Is anyone else experiencing slow ERA loading time since the update? Some of our ERA's take from 3-5 Minutes to load (this is a very large ERA).  Is anyone else experiencing this? 

We have also been noticing slow time on Payments module as well....

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Wrong Payer adjustment

KELLY PERFETTI 5 years ago in Billing/Electronic Modules updated by Mark Cornell 5 years ago 3

Is there a way to clean up an account if you happen to bill the wrong insurance to get rid of that line and only have the correct insurance line. I find that when I run the 1010 report and it shows the Amount column that I have to subtract the Wrong Payer adjustments to get the correct amount billed out. Anyone else have this issue or know of a way to get rid of the incorrect payer line other than adjusting it off.

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MHCP told us that the DX Code F99 No longer valid

Tanya Milner 5 years ago in Billing/Electronic Modules updated 5 years ago 8

Has anybody else been told F99 is no longer a valid code? MHCP told us that a claim did not get paid because as of June 2019 this code is no longer being used.

If this is the case, is there another code that will replace it? We use this when we do not have a specific DX for a client yet.

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Rates

Leah T. 5 years ago in Billing/Electronic Modules updated by Richard Sethre, Psy D , L P. 5 years ago 9

Outpatient mental health clinics- Do you have the same rate for services across all insurances and if so does it make your adjustments look high at the end of the month since a commercial insurance might pay more than MA? 

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MA client seen at 2 clinics in same day

dianef 5 years ago in Billing/Electronic Modules updated by td vanovermeiren 5 years ago 2

I have a therapist who saw a client for a DA, and the billing was denied because the client was seen at another clinic on the same day. (CP case) Is there any way to get reimbursed for that DA? Crisis add-ons wouldn't work?

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Tracking residential attendance

Jenna 5 years ago in Time Module updated by Valerie McNamara 5 years ago 5

Hello, 

I am wondering if anyone would be willing to share their system for combining tracking of attendance to the billing. We are a 108 bed facility and needing a better system in place to be able to communicate when and why someone left and when they came back. We are having gabs in this connection of information. 

Thanks! 

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bcbs pmap

amybenson 5 years ago in Payments/ERA Modules updated by Shauna Dall 5 years ago 8

Is anyone else still receiving a short pay on claims from BCBS PMAP? I bill for H2012 UA HK and the DHS rate for 1 hour is $65.26. BCBS PMAP prior to January 2019 paid $67.21 a hour. Now I am receiving $32.39/$32.38 a hour across the board. I have asked for "Project" to be opened to capture my incorrectly paid claims and have not been successful with customer service at Amerigroup. Our Provider Rep doesn't respond back to any emails or phone calls. Any advice or what is everyone else doing?

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Things To Be Aware Of - Next Steps

Katie Sandquist 5 years ago in Known Issues updated by Amanda Kaufmann 5 years ago 13

Good Morning,

We have successfully moved Procentive to a new hosting system.


The first item for you to be aware of is to clear your cache.

Clear your cache in Google Chrome

Clear your cache in Internet Explorer

Clear your cache in Safari

Next, if you receive a message in Clinical/Charting that reads, "You do not have permission to view this Clients chart", Clear your Cache.  See above for those articles. 

In the Electronic Module, for any claims sent between 6/18-6/21, you will need to read the Response Report, even if the status column still says "sent".  The reports came back in during the transition but the status was not able to update.  We can confirm that this is fixed moving forward, but the status will not update for reports that were received on 6/22.