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CTSS Day Treatment

amybenson 7 лет назад в Industry News/Discussion обновлен Missy 7 лет назад 2

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.

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Does anyone use a provider enrollment service?

Jonathan Beulke 7 лет назад в Payers Module обновлен anonymous 7 лет назад 2

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!

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alternate client ID #'s

Calah Hansen 7 лет назад в Clients Module обновлен 7 лет назад 3

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?

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Performance Report

jmathwig olson por 7 лет назад в Reporting Module обновлен 7 лет назад 4

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! 

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FSA client payments: refunding or getting them itemized receipts

crystalp 7 лет назад в User Group Help обновлен Laura Graff 7 лет назад 3

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?

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H2017 Medicare equivalent?

Kayla Kenworthy 7 лет назад в Billing/Electronic Modules обновлен sarah 7 лет назад 1

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?

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Medica network Rep

crystalp 7 лет назад в User Group Help обновлен Mark Cornell 7 лет назад 3

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.

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How do your clinics and providers choose a taxonomy?

crystalp 7 лет назад в User Group Help обновлен 7 лет назад 4

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.

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Is anyone having issues with claims not crossing over to Medica from Medicare?

Tina B 7 лет назад в Billing/Electronic Modules обновлен Laura Hulsey 7 лет назад 1
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KNOWN ISSUE: Cigna Claims Have Rejection

Ashley M 7 лет назад в Known Issues обновлен 7 лет назад 0

We received notice from the clearinghouse that claims submitted to Cigna from 10/01/2017 - Current  may have rejected in error with the following message:

A3:688 - Acknowledgement/Returned as unprocessable claim-The claim/encounter has been rejected and has not been entered into the adjudication system. Present on admission indicator for reported diagnosis code(s).

Any claims rejected in error with this code have been identified by Cigna and will be reprocessed. No further action is required.


Have a great weekend!

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