...and getting reimbursed.

Thanks,
Kim

Is anyone currently billing or had any success in billing for assessments such as the PHQ, GAD, etc?

We are wondering if any clinic has successfully billed for the scoring and writing up the evaluations for ADHD testing, this would be without patient present of course.  What codes are you using?  We found code 96127, however most insurance companies are only allowing payment of $5.00-$10.00 which is extremely low for the amount of time the clinician is spending scoring and writing up the evaluation.  Any information you can provide is appreciated.

Any insight you have may help.  

An employer is reimbursing a patient for a copayment and they are requesting as of October 2018 DOS are now asking or the following on the receipt:

"The IRS asks to include on the receipt: Amount, Method of Payment, The Diagnosis code, Treatment Plan, and Dr's information: Name, facility and National Provider's Identifier."

I've provided the receipt from the copayment made the same day and the HCFA 1500, but the Treatment Plan, and Diagnosis Code?  It seems a bit excessive. I may be wrong about it.

Does Procentive have a report that can run all of the above on one form? 

Does anyone have an effective way of alerting staff that a former client cannot be rescheduled until they have paid toward a balance? 

Our scheduling staff are different from billing staff, and we need a way to communicate to the scheduling staff when a particular client needs to pay/set up a payment plan before they can be scheduled. 

This is a sticky situation, but does this happen to any other agency, and how do you direct/navigate the guarantor to resolve these issues?

Client is a minor whose primary insurance is through biological father, secondary insurance is through MN Medical Assistance.  The primary insurance through biological father lapsed, and we’re told there is no way to contact biological father to verify primary benefits or inquire.  If we send the claim to MN Medical Assistance, they will deny because they have biological father’s insurance on file as a Primary.  Feels like we are stuck.  How do you get the wheels moving forward on this?

I am trying to bill Medicare for Substance Abuse treatment for chemical dependency. We have a client who has Medicare as the primary provider and the secondary payer is Health Partners - PMAP. When I called Medicare to inquire about submitting a claim, I was told that I can't submit a claim to even get a rejection to send to the primary, because Medicare does not cover CD treatment. Has anyone else had this issue? Any help would be greatly appreciated

Victoria Petrik

Does anyone know if it is possible to bypass a primary payer that does not except our codes when the client has a secondary payer that does except them? I.e. Modifier? 

NOTE - primary is NOT Medicare or a Medicare Product. (We use GY)

We are new to Procentive and I have a couple issues I could use help with. The first one is I am having trouble with rejections from Hennepin Health ,first on was about service codes fixed that resubmitted now the rejection is "service line days" looked at the X-12 summery and claims looked good! Anyone have any insight? Next pertains to BCBS Private claim we as a company do 96% consolidated and Pmaps, when I submitted BCBS paid one day on both claims called them and they said for Private I should not send HPCS  or modifers on a Private claim. does not seem correct to me. Would appreciate any help