I am having an issue of OP CD  sending as an admit to discharge on the UB04. I am not sure what setting to add to avoid this and not have to edit that each time. My understanding is you have to send with an admit date as they are in a specific program. Any advice is much appreciated. '

The only setting I could see that would help this is editing the "outpatient" to "inpatient" under residential so the claims sends with its proper 862/863/864 etc. 

Thanks! 

Is anyone else experiencing delayed payments for institutional claims with Blue Plus and Ucare?

Hello,

Wondering if our outpatient groups are entering time for just over 45 min. Can we bill the hour? Or how do we edit this ? 

I know with mental health there is a approved "gap" if it is greater than x amount of time you can choose the appropriate code. 

Wondering what that is for OP CD group. 

Hello - we have been billing Treatment Coordination (T1016 HN U8) for a handful of months and now want to look into billing this service when client is not present. 

I know that we are able to do this but have some questions I am hoping someone can provide some insight into:

1. Since the client is not present as long as it is noted appropriately it should not be seen as duplicate billing? i.e. the client is in group at the same time the TC is being completed without them present.

2. If TC is occurring through out the day in smaller increments can we bill for 1 unit if it totals 15 minutes? 

3. Any clinical documentation guidelines outside of the norm?

Thank you - Jeremy RL

I just noticed that the payer id for DHS looks different. Says MNMAG? What is this all about? And for some strange reason I am unable to open the data link in the Billing Module for any claims generated today. When I click on the data link, I either one or two error pages open instead.

Thanks, Sara

I can't get back into Procentive to send a ticket but I was kicked out after extra, error tabs opening. Others in my company are also experiencing errors

Has anyone else seen denied claims from BCBS pmap (LMN... policy) and been told it is because the member is in a Restricted Recipient Program? 

This note is from MNits regarding this type of policy/program:

Restricted Recipient Program:

Some MHCP recipients are required to receive the following services from specific providers: Inpatient Hospital, Pharmacy, Physician Services, Mental Health, Outpatient.

The frustrating thing is that you do not know the member has this "restriction" unless you actually call BCBS or first check Availity and then check MNits. It is NOT indicated on Availity at all. So when a client gives you their BCBS pmap card and you check Availity for active coverage, you then have look at the image of the card to get their MA #, then login to MNits to see if they have this type of program. 

Also, the BCBS rep told me authorization is NOT an option for this type of program and our only option for possible payment would be to appeal for medical necessity. 

Help anyone! Thanks, Sara

Does anyone bill out 99408 and 99409 It is a public health approach to screening and early intervention to help identify, reduce and prevent substance use.  If so, have you been successful with getting paid? Thank you

Is anyone else having issues with getting their faxes today.  We haven't received a fax in a day in a half.  Wondering if this is a Procentive issue or what issue it could be

We have a lot of in-home staff that are having issues logging into procentive from their laptops at home.  Is this an issue that anyone else is having?