Has anyone billed CTSS codes lie H2014 with UA modifier to commercial payers and have had reimbursement success? Or should we just skip billing primary commercial payers and bill directly to MA/PMAP? Have you had to put PR 96 on the COB info since commercial payers do not reimburse those services/codes? Thanks in advance.

Good morning!  I am wondering which report is commonly used to cross reference ERAs in Procentive with our bank statements?  I am looking at 1140 or 1370, but don't know which fields to fill in that will show me this info.  I'm currently getting too much detail.  I don't need client names, or each individual payment.  I just need the date, payer, and total check amount. 

Thanks & have a great weekend!

Jill

I did an analysis of billed R69's to see who was paying them. (These are generally a first appointment with a parent only--90846.) We have been paid for this diagnosis by Health Partners, PrimeWest, BCBS, Preferred One and America's PPO. We have not been paid by Medica or MA. Their denial description states "Diagnosis not consistent with procedure".

Is anyone billing this as a Z71.1 or a Z03.89? Are you being reimbursed by Medica and/or MA? Thanks in advance!

Sheryl

Here is the link that is associated with my question: Regarding MA/PMAP Plans.

Debbie

In order to prevent errors in claim submission and speed up the payment process for customers, Procentive recently started scrubbing claims data for extra spaces in areas like the client's name, address, policy ID, etc.

Today, for certain payers (not all of them), the system is showing an error that says, "The client's middle name may not have spaces before or after." In some cases, the error is a false error (meaning, there is not actually an extra space in the middle initial).

This problem will be resolved by tomorrow morning, as soon as our system updates overnight tonight.

Once the solution is confirmed to be working, we will update this post.

Thank you,

Kevin Holmes

We are currently experiencing an issue and we're working to resolve this. It should be back to normal shortly. Thank you for your patience.

We are experiencing slowness everywhere

Is it possible to associate completed forms with multiple programs without being required to upload a document twice? For example, we provide ARMHS (1:1 mental health service) and Adult Foster Care and require current Diagnostic Assessments for each program. Often our clients will be using both of our programs simultaneously. When we receive a DA from their psychiatric provider, I'm currently required to upload the DA twice into Procentive in order to associate the DA with each program. Does anyone know if it's possible to assign a document to both programs at one time?

is this happening for anyone else?

Hello,

Has anyone had claims deny from Health Partners with the code 50 (These are non-covered services because this is not deemed a 'medical necessity' by the payer.)?

Since January 1 all our psychotherapy codes have been denying with this code...weird.

Thanks