As of this year there is a new requirement for outpatient counseling for UCare for Seniors clients. A prior auth is required for anything other than an intake. This caught us by surprise and the provider newsletter it was featured in was very obscure.

Has anyone else experienced consistent denials with Aetna for med mgt codes: ie 99213, 99214, & 99215 for various reasons including no authorization, no referral or provider type cannot bill this procedure? Every time we call to see exactly why it denied, we get different answers. I've spend 1 hour today, trying to get to the bottom of it and I still don't know if I'm clear with what we need. Some reps say the plan needs a PCP referral, another rep says we need pre-auth, pre-cert dept says it's not needed for mental health, some say add modifier 25, etc... help!

Procentive is running very slowly. Some staff are seeing display issues (what they just entered not showing up). I already have a dozen email messages from staff about it at many locations, so we have ruled out a connection issue.

Paper charts were easily shredded when the threshold of record keeping was reached. What are folks doing for inactive clients to purge clinical records when the threshold of keeping records occurs?

Hi -

I have a question about programs. We use MN Waivers and someone could use multiple services under the waiver. We currently have waivers set up as the program, I'm not sure how to go about setting up different "paperwork sets" for each of the services, since each service needs it's own treatment plan and progress note with outcomes set to each service. Has anyone else dealt with something like this? How did you deal with it?

Thanks!

We are aware of a problem in clinical permissions that may prevent staff from seeing certain documents that they should normally be able to see. Staff should be able to see their own documents, but may be prevented from seeing documents for other staff. We are working to resolve this issue right now and will update this post as soon as the problem is fixed.

We run the 3560 statement each month however when we first started using it we were told (by Procentive) to run it from 1/1-2/10 is there a reason we should be sending a month and a half worth of charges or was this suppose to be a one time thing and not relayed? Also, how do you run an itemized statement for a specific date (ie: rather than sending a receipt for payment they would like an itemized statement for the payment)

Procentive is currently experiencing repeated logouts for clients on one of our servers. Our engineers are working to resolve this issue as quickly as possible! Please check back here for updates.

Our chat vendor is currently experiencing intermittent issues that prevent us from accessing our chat software. The vendor is currently working to resolve the issue but there is no resolution time currently available. Please check back here for updates!

There is currently an issue with the way that Procentive is calculating the internal bill amount for secondary invoices. The claim is correct, but the internal bill amount for secondary claims is not adjusting based on the prior payments and adjustments from the primary payer.

This issue was introduced on Friday. We are currently testing a solution and hope to have the fix loaded by the end of this week. As soon as we know for sure when the fix will be available, we will update this post.