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Blue Plus and Testing

Melissa 7 years ago in Billing/Electronic Modules updated by Ashley Kallod 7 years ago 1

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. 

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Add on Psychotherapy codes 90833, 90836 and 90838

We are looking for clarification on understanding of time/minutes for the 90833, 90836 and 90838.  Per the CPT code book a 90833 is 30 minutes of psychotherapy with patient when preformed with and E/M service.  We took a few trainings a few years back when the 90853 med management and 90805 med manage w/ psychotherapy codes were removed and were informed that we could bill a 90833 for any psychotherapy provided outside of the E/M time for time spent between 16-37 minutes. i.e Prescriber did 99213 E/M services then provided 18 minutes of psychotherapy so they would bill the add on code of 90833 in addition.  What time/minutes do you associate with the add on psychotherapy codes?  We understand that no one can advise on what to bill just want clarification on the minutes or span of minutes for each code. 

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Constant Rejections by BCBS

Chris 7 years ago in Billing/Electronic Modules updated by Caleb Zimmermann (Customer Success Manager) 7 years ago 1

Does anyone else bill BCBS for substance abuse? We are constantly getting rejections by BCBS, and the status is always vague:


Error Message:         Category: Acknowledgement/Rejected for Missing Information  The C
laim/Encounter is missing information specified in the Status details and has been rejec
ted Status: Information submitted inconsistent with billing guidelines. Note: At least o
ne other status code is required to identify the inconsistent information.


This happens to probably 75% of the claims I bill out, and I can't seem to pinpoint why...

Answer

Hi there Chris! 


We actually have an article in our knowledge hub specifically about this error. Check out this link and it should answer a lot of the questions you have.


Article: At Least One Other Status Code Is Required


Hope it helps! 

Caleb

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Resend claims not working?

Heather H 7 years ago in Payments/ERA Modules 0

For two days now, my team has been trying to resend claims (from an invoice/claims tab) and all we get is a blank white box.  Is this feature currently broken?  

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two appointments in one day for same client

Jenny 7 years ago in Appointments Module updated by anonymous 7 years ago 1

Has anyone had the same client require two separate calendar appointments in the same day? If so, how where you able to document both sessions as separate appointments?

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Video uploads to clinical charting?

Kim Ross 7 years ago in Clinical Charting Module updated 7 years ago 2

Has anyone tried or been successful with uploading video clips to clinical charting?

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Fixed

KNOWN ISSUE: Claims sent to MN MA (DHS) have a status of "No Response"

Ashley M 7 years ago in Known Issues updated 7 years ago 3

All claims being sent to MN MA (DHS) are coming back unacknowledged with a status of "No Response" in the Electronic Module. We are working to get in touch with DHS for more information and to find a resolution.


Please watch this post for updates. Thank you!

Answer
Ashley M 7 years ago

Per DHS this is now resolved with the exception of 270 Eligibility Requests for some providers. 


For claims that have a status of "No Response" in the Electronic Module, please open the batch report:

  • If there is a file listed here the claim has been received by DHS.
    • Example: 999 file A6813856700_999_837P_20170101_A6813856700_837P_20170101_4239846.dat (no errors)
    • Any files that contain errors will need to be addressed as normal.
  • If there is not a file listed here, please resubmit the claim.

For 270 Eligibility Request: If you do not receive a 271 response, resubmit the 270 transaction.


Thank you!

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Fixed

KNOWN ISSUE: MN MA (DHS) Scheduled Downtime

Ashley M 7 years ago in Known Issues updated 7 years ago 1

We have received the following notice from DHS:

All functions of MN–ITS will be unavailable from Saturday, August 5 at 6 a.m. until Monday, August 7 at 6 a.m.  while we do system maintenance. During this time all of MN–ITS will be unavailable, including:
•  All Direct Data Entry (DDE) transactions
 All applications and systems that require users to log in to MN–ITS
 All eligibility verification transactions, including phone verification
 The MPSMISC file will not be available for uploads or downloads Batch transaction processing – All batch transactions will be unavailable, including secure FTP servers. You will not be able to submit any files during this time. (Pub. 7/22/17)


What does this mean for you?

Eligibility through Procentive will be unavailable during this time. This may also cause claims sent to MN MA (DHS) to fail.  All DHS systems (e.g. MN-ITS) will also be unavailable during this time.

We ask that you please wait to send claims to MN MA until their system is restored on Monday, August 7 at 6 AM


Please contact the Procentive Support Desk with any questions. Thank you!

Answer
Ashley M 7 years ago

This is now resolved.

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Medica and MHCP no longer accepting GY modifier

Tanya Milner 7 years ago in Billing/Electronic Modules updated by crystalp 7 years ago 1

Medica and MHCP are no longer accepting the GY modifier, they state that they have to have the primary EOB, but we can't send claims to Medicare if the provider is not in network, meaning we can't send the EOB. Ideas, thoughts?

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Looking for information on billing 99354/99355 amd 90839/90840

Tina B 7 years ago in User Group Help updated by sfoster 6 years ago 9

Both 99355 and 90840 are for each additional 30 minutes. For a 2 hour crisis you would bill

90839-90840-90840. How do you bill the same code on the same day? Or do you set the code up as 30 min = 1 unit?