Good morning!  I am wondering what experience others have had with billing the testing CPT codes. The specific tests I am looking at would be the MMPI and the MAPI.  I believe this would fall under the 96101?  Some of the questions I have on this is - what is the reimbursement rate like?  How many hours are you able to bill for?  Are you paid separately for the test administration and the write-up or is this one code?  Does this need to be billed along with a DA?  If anyone has a chance to give their thoughts on this it would be greatly appreciated!

Thanks & have a great weekend!

Jill

We are not getting outpatient BCBS ERAs in Procentive.  Payments are posting, we have to go onto Availity to download the ERAs.  Is anyone else having this problem?  For example, we have check  date 5.9 for Bluelink TPA and CCSTPA, but no ERA is in Procentive.

Good afternoon Procentive Community,

I was just made aware of a G code that we could use to bill Medicare or bill Chemical dependency  services for clients that have Medicare advantage policies. I found the following two codes online :
G0396 (Alcohol and/or substance abuse structured screening and brief intervention services; 15 to 30 minutes) and G0397 (Alcohol and/or substance abuse structured screening and brief intervention services; greater than 30 minutes). I called Medicare and was told that the two codes were covered and there is no limit as to how often we are able to bill them. I would however like to know a little more about the two codes before I add them in procentive. Has anyone heard of the two codes? Do you use them often? Does the rendering provider need to be Medicare eligible? Do you use the two codes just for the assessment or for the individual and group sessions as well? If you only use them for the assessment what codes do you use for the individual/ group sessions afterwards?    

Thank you!

This morning we received the following notice from MN MA (DHS):

...We are seeing slow response times and errors returned for our Eligibility Real Time 270/271 application.  I will send an update when I have more information regarding this issue.

What this means for you:

Until further notice from MN MA, eligibility run through Procentive may be slow and/or have errors. When we are notified this has been resolved we will update this post.

Thank you!

Is anyone using G-codes and other tracking codes for quality measures and reporting them to the insurance plans? 

If so, are all payers allowing them to process through their systems, such as Commercial plans, MA/PMAP plans, and Medicare?  Or are they rejecting the claims because of these codes?

We are going to be using some that will be tracking BMI (G8417, G8418, G8420, G8422, G8938, G8421 and G8419), Tobacco screening (4004F, 10036F, 4004F 1P, 4004F 8P), Alcohol (G9621, G9622, G9632, G9624) Suicide risk (G8932, G8933), Screening for clinical depression (G8431. G8510, G8433, G8940, G8432, G8511), and PHQ9 (G9511, G9509 and G9510).  Wondering if anyone else has any experience with these codes.

Thank you!

I have noticed that, besides UBH, the payout difference on a 90791 and a 90837 is only a few dollars. Have others noticed this? Should I be negotiating a higher payout on 90791s?

We've been informed that the 1370 Report is not displaying the correct data for some customers. Our engineering team is working to update the 1370 Report and resolve this issue. Updates will be posted here as we receive them. Thank you!

In an effort to further improve performance, Procentive has made changes to the Eligibility Module and Clinical Charting Module. Most of these improvements will not be visible to you (they are behind-the-scenes improvements to the code). But there are a few changes we want you to know about:

-Eligibility Module- You will only be able to re-sort (by clicking on the column-header) with the client and payer columns.

-Eligibility Module- Instead of showing all client appointments for the date range, Procentive will display only the next three appointments. If you need to see all of the client's appointments, you can still access them by clicking on the client number, which then opens the client dashboard.

-Eligibility Module- The Quick Search and Advanced Search will no longer be available. As an alternative, we suggest using the search tools at the top of the screen (for client and payer). Or you an use the "Find" tool in your browser, by clicking CTRL +F on most PCs, and Command +F on the Mac. The Find tool is a great way to search for a client's payer ID, for example.

-Clinical Charting- Searching is now more optimized with greater speed when loading the results and allowing you wider searching for all staff, all clients, NOW up to a 90 day range.

If you have any questions or comments, please send a ticket through the Procentive Support Desk. Thank you!

Our practice would like to be able to keep documentation on our staff on file in Procentive, but I am not aware of a method to do so. We would like to be able to record notes, staff reviews, tax documents, disciplinary action, etc. within Procentive in a similar manner as we do with our clients. Is this possible?

Thanks in advance!