Has anyone else billed Tricare for Residential Treatment?  No matter what revenue code I use, Tricare is rejecting my electronic claims and I cannot get them to go through.

Hi all, Not sure I'm posting this in the correct forum. I'm looking for some information about coding for interactive complexity for clinicians doing play therapy. When adding this to 90837 or similar service line, do other clinicians typically record notes for both service lines or is a note for only one (or the other sufficient)? Our interactive complexity codes got denied and they were added at the same time as the main service code but notes were only included with the 90837 line so wondering if that was the problem. Any help with this would be welcome.

I'm fairly new to Procentive, so this subject may have been covered...

I got a calim back from UCare. It has takebacks which are fine...after processing almost everything in the claim, I'm still 2.77 short for a payment on a claim. That amount is in the left hand corner of the ERA in a blue dotted box  that says:

Date              Code        Adjustment

12/31/2017    L6:IX        2.77

Is that available to use? If so, how do I process it? I found information on the Procentive Knowledge Hub about interest payments, but that doesn't seem correct.

TIA!

Hello , ,

Is there anyone who can provide information regarding CPT Code 90889. What kind of process do we need to follow to get reimbursed for this codes. Is it covered by PMAP plans, MA, Commercial Payers, if so which ones?  Does it require prior authorizations. Thank you.

Is  anyone else having issues with Procentive right now? it will not open any windows/client modules ect..

Procentive servers are down right now. We are working to resolve the issue ASAP and will update this post once we have more information

UPDATE:  The servers were successfully brought back online at 11:32 a.m. after Procentive identified an outage at 11:15 a.m.  The system operations team identified the problem and took action to confirm a solution and the system has been stable with no lingering effects.  On behalf of the Procentive team we apologize for the disruption this caused you this morning as you cared for your clients.  Our aim is to always seek to serve you as quickly as possible in any situation. Thank you for allowing us to partner with you in providing great care to your clients.

Pat Stream

Director of Customer Success

How many of you find it difficult to work with the BCBS Affiliates and their Blue Card Program.  It seems our experience goes one of 2 ways...either the UM/claims go through without an issue or we have nothing but an issue out of the gate (often it revolves around coding...specifically the H205 (HQ).  The struggle is they want us to bill a per deim code when statutorily the H2035 is all that is available.  It is when we have an issue that rarely is it fully resolved.  Currently we have 3 active claim issues one dating back to 2015.  BCBS-MN seems to give it a half hearted attempt to resolve.

HI all,

We would like to have a Workflow to remind staff when an authorization form needs to be completed to request more sessions.  We currently use the MN Universal Form, UCare Auth Form and the DHS MA Auth Form.  I am trying to figure out how to set-up a workflow so that the right form is attached to the related record.  Thanks for your ideas!

Calah

Recently for Blue Plus when billing out individual lines of 96101 they will pay on one line and deny the others saying it is duplicate.  I was told that I now have to use a modifier to bill these out? What modifier should I use? I am only having this issue recently with Blue Plus.