Good morning!  I am wondering if anyone has advice on managing the process of reimbursement rate changes from our various payers.  Do you rely on the bulletins that are sent out or do you just watch the EOBs to know if/when rates change?  Or do I need to be going online and watching fee schedules?  If you are able to respond and let me know how this is done at your organization I would be grateful.

Thanks & have a great day!

Jill

Good afternoon!  This may be a basic question, but at the risk of sounding "un-informed" I'm going to ask it anyway :)

I was recently made aware that a modifier can be used on claims to indicate when a client has a co-occurring diagnosis.  For example, a chemical dependency diagnosis along with a mental health diagnosis.  I was told that this could potentially result in a higher payments.  Do you know if this is the case and what that modifier is?

If you only have 2 clients enrolled in a day treatment for the 3 hour group sessions. An Statute states you have to have 3 "enrolled" to be considered day treatment. Can you bill out "individual skills" for 2 hours until more clients enroll to become a group again? Low numbers are due to discharging clients and no new referrals at this time.

Our practice needs to enroll with 4 different insurance companies and are looking for ways to make the enrollment process easier in general.  Does anyone know of, or use, a service that will enroll our practice to these payers for us?  With how time consuming the credentialing process is, we're hoping to eliminate the headache.

Thanks!

We have several programs that report to funders with alternate client ID #'s instead of the Procentive Client ID #.  For example the MN-ITS Client ID#, HMIS Client ID# or the HCM ID# for the SLMH groups out there.  It would be nice to have a spot to capture these alternate ID #'s in Procentive.  How have other people handled this?

Does anyone have suggestions on what Procentive report to run to collect data on the number of clients served in a particular program, broken out by Payer, age of client, county of financial responsibility and during a particular service period? I need to make sure that my data is not duplicated. For example, we often have clients enrolled in multiple programs within our agency. I only want to count each client once despite being in more than one program. 

This report may sound familiar to those users living in Hennepin County and completing the Hennepin County "Contracted Services Performance Report".  

Thank you! 

Does anyone know the legalities or tax issues related to FSA $. We have a client who was paying co pays with his FSA but after a certain amount of visits, his insurance started paying in full but he still was paying some co pays. Now his FSA administrator is asking for an itemized receipt but we can't really give him one because we did not allocate the payment. Can we refund the client and he then has to send the $ back to FSA account? Suggestions?

Hello! So, I had a patient call regarding Medicare denying our ARMHS code, H2017. She called Medicare and said I submitted it incorrectly. When I called Medicare, they said that the code had an "I" next to it and I'm submitting the wrong code.

Is there an equivalent Medicare approved code that would cover this type of service? Or am I getting mixed answers?

Does anyone else have problems finding out who their Medica/UHC/Optum network rep is? We have had many different reps over the past 4 years and currently, we have tried getting in contact with someone and we still have not pin pointed who that person is and get no response from anyone at Medica. It's very frustrating as we have contracting questions, consistent denied claims for IOP, etc. Who would like to share names and contact info of people you have at Medica who may be able to help us? THANK YOU.

Anyone know if there is a special science to choosing which taxonomy code your providers or clinics send with claims? Is there a right or wrong taxonomy code? Do we just need to choose whichever one fits the clinic or provider the best? I appreciate any suggestions.