I haven't seen that our ERA from DHS come in.  Does anyone know if there is a delay?

Does anyone have a solution to billing claims for LPC for individuals with Medicare as Primary?  I have an individual who wants to see our LPC, but has Medicare as the Primary insurance.  BCBS is secondary and they are denying claims stating it needs to be sent with EOB information from Primary.   What is the best way to get this claims processed by BCBS?

Could someone tell me the code that you are billing for on a External DA review and a Explanation of findings

Hi, I am new to contracting and my supervisor wants me to get us set up for IOP for mental health.  I see some insurers require us to be contracted as a facility but others, it does not look that way.  Do you know, do we need to be contracted as a facility and bill on a UB04 or as a clinic and bill on the HCFA with the H2019 codes?  any help is very much appreciated as I am quite confused.

Has anyone else been hearing from customers today about not getting appointment reminders?

Has anyone submitted them to a PMAP yet?  I'm submitting some test claims to see what happens.  Is is always comforting to know that PMAPs don't know what diagnoses work with your systems.  They just respond to denials.

Is anyone else having issues with many denials on recent BCBS PMAP payments due to the "197" code.  Will pay the 9 code, but deny the travel due to the "197" code. Or won't pay on either code due to the "197" code. 

We were finally able to successfully bill the enhanced rates on our room and board line. It has always been on the grid rate sheet but we never were able to get it through. We billed enhanced rate with with child (U6) and medical (U5). After a few phone calls with DHS and asking the right questions we were able to bill directly on the MN-its website and get paid. 

Now when setting up our current clients with the room and board plus modifiers in Procentive it cannot clear their system. They say that DHS has been made aware of the issue that when sending in batch form it will not clear a revenue code with modifiers. Only a CPT code with modifiers. 

They also said that most people (like us before) just end up getting paid the base rate. So to test it out first. If entered right on MNit's you can get paid for this. It is a substantial amount of money over the course of a year billing out these rates. 

We are wondering who else is having this issue and if enough of us raise and issue with Procentive /DHS  the proper changes can be made so we can bill out of Procentive without having to go into MN'its directly to edit and bill the Room and Board w/ mods for every client in the facility. 

We are going to start billing for Urine Drug Tests for our COD program and we received a CLIA waiver. I see in the payers module > rates > codes tab that there is a filter that says "Use CLIA code on claim"...does anyone bill UDTs and send their CLIA code with claims? Do you know which payers require it? Would is be best to contact provider services for each payer or our network reps? Specifically, the code we will bill is 80305 QW. Thanks for any help as this is brand new to our clinic.   

Does anyone else have a process through Procentive set up for combining multiple practitioner's claims for CD services on one UB claim per day?  BCBS is requiring this.