If you have a client whose secondary payer allows more than the primary payer and the secondary processes the claim by paying whatever the CCD was from primary but still owing CCD, do you charge the client or adjust it off, since the secondary covered a minimum of the CCD from primary? Ie. primary Health Partners has a lower allowed amount for a certain code than secondary BCBS. HP has a $25 co pay. BCBS pays the co pay, sometimes more, but then is also processing the claim with CCD up to the BCBS allowed amount (which in this case is pretty decent amount). Do you charge the client the difference or adjust it off since you were paid by primary and the secondary covered the CCD from primary? Thanks. sorry it's confusing to explain this.

Is anyone else experiencing substantial slowness with Procentive at this time?

Does anyone have any best practices that can be shared when it comes to the first of the year where benefits(not eligibility) need to be re-verified and releases in the client module need to be updated?

Currently, we end up with a tone of paperwork that ends up having to be scanned.

Thanks Much!

I've been noticing the last few Ucare PMAP ERA's have been denying every claim with a "UA" modifier. Is it something I'm doing wrong, or is it an issue with UCare? Anyone else been having these issues?

Good afternoon!

Our organization is trying to determine the most accurate report that will tell us how much we have been paid based on date of service.  For example, for services that were done during the month of July 2017 how much did we actually get paid.  We only want this to be payments, takeback credits, and credits.  How do we also take into account takebacks?  My thought is to run Report 1370 and filter by date of service and then include the fields Amount Paid, Credits, Takeback Credits, and Takebacks.  Anyone else have experience with this?

Thanks & have a great day!

Jill

Hello,

It has been brought to our attention that Dr. First is currently experiencing an issue that effects newly enrolled providers. If you have recently completed the activation process for Dr. First, but are not able log on to the medication Module, please send a trouble ticket to Procentive. This bug will only effect a newly enrolled provider’s initial log on to the Medication Module.

Any additional updates will be posted to this Known Issue as they become available.

The LP at our clinic is giving away testing materials that she does not use.  If you could use these materials, I will send them to you.  We would ask that you pay for the postage.  Please email me at Paulacfcinc@gmail.com if you are interested.  Thank you!

25 copies  - Conners ADHD Rating Scale - Parents Form

25 copies - NEPSY II - Second Edition - Ages 3-4 - Record Form

25 copies - NEPSY II - Second Edition - Ages 3-4 - Response Booklet

20 copies - Wechsler Nonverbal Scale of Ability - Record Form

20 copies - Wechsler Nonverbal Scale of Ability - Response Booklet

Good morning!  I am wondering if anyone has advice on managing the process of reimbursement rate changes from our various payers.  Do you rely on the bulletins that are sent out or do you just watch the EOBs to know if/when rates change?  Or do I need to be going online and watching fee schedules?  If you are able to respond and let me know how this is done at your organization I would be grateful.

Thanks & have a great day!

Jill

Good afternoon!  This may be a basic question, but at the risk of sounding "un-informed" I'm going to ask it anyway :)

I was recently made aware that a modifier can be used on claims to indicate when a client has a co-occurring diagnosis.  For example, a chemical dependency diagnosis along with a mental health diagnosis.  I was told that this could potentially result in a higher payments.  Do you know if this is the case and what that modifier is?

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.