I am looking for ideas on the best methods for documenting couples/family services.  We like to have each person complete an intake form and enter each separately into the system.  When scheduling appointments we would like to avoid non billable service lines popping up in the 1300 report, and avoid duplication in tracking.   The goal would also be to avoid having to duplicate documentation for each couple or family.  Any thing that had worked well for you guys?  

CTSS Providers: When a client ends CTSS, how are you also ending, at the correct time, the addition of the UA modifier to service lines? The UA modifier (managed in the client module > payer tab > MN Medical Assistance Program drop down list) is added when the service lines are billed, not when they are created. Therefore, if a client is discharged from CTSS but continues to receive other services, how is this accurately managed?

IS anyone a behavioral health facility and billing for a nurse practitioner.  We got denied claims for MN MA and were told to either remove rendering provider or bill nurse practitioner as Nurse practitioner.  Any suggestions?  T

This article is no longer accurate. Please review this topic instead.

As of January 1, 2018 Tricare will be making the following changes:

• Claims contractor will no longer be PGBA
• New claims contractor will be Health Net Federal Services (HNFS)
• North Region and South Region are being removed
• East Region will replace the previous North and South Regions

What does this mean for you?

If you are a Tricare provider and would like to continue receiving EFT and ERA, you will need to fill out and submit the following applications:

• For ERA: Tricare 2018 ERA Pre-Enrollment Application
• For EFT:  Tricare 2018 EFT Pre-Enrollment Application

You may have received these applications in the mail however, we want to make this process as easy as possible for you so we have re-created these paper forms as fillable PDF documents! 

Please submit these completed applications to:

HNFS at 1-888-282-2841 Attn: T2017 West EFT/ERA

AND

Procentive at 1-888-354-9053 (ERA application only)

If we do not receive a copy, we will be unable to assist you in the application process.

Thank you!

I have multiple claims that are being denied because Medicare isn't putting "Contractual Obligation" in the COB when we forward our claims to a PMAP. So, it makes it look like there is no beneficiary obligation to the PMAP. Anyone know if this can be fixed? Or what the easiest process would be?  It's impossible to talk to someone at Medicare, so I figured I would check here

I am wondering if anyone else is having issues with the primary EOB information being sent along with claims? I have noticed with our Wilson McShane (BCBS) claims and some of our UCare PMAP claims, we send it to secondary with the primary payment information added into the "COB" tab in Procentive and they still come back denied. For many of the claims I have to fax in paper copies of the EOB's otherwise the secondary insurance cannot see it any they deny. Any suggestions?

We have received notice from the clearinghouse that claims sent to Cigna after August 19, 2017  with any of the following diagnoses were rejected in error:

The affected claims were rejected with the following rejection messages:

A3:254 - Acknowledgement/Returned as unprocessable claim-The claim/encounter has been rejected and has not been entered into the adjudication system. Principal Diagnosis Code for Service(s) Rendered.
A3:255 - Acknowledgement/Returned as unprocessable claim-The claim/encounter has been rejected and has not been entered into the adjudication system. Diagnosis Code for Service(s) Rendered.

If this applies to you:

Cigna is working to resolve the issue.
•  Claims that rejected on or after 08/20/2017 will be identified and corrected.

•  No action is needed. Estimated Completion Date: TBD
•  An updated batch report will be sent upon the correction of the rejected claims.

Thank you!

Are any other practices having issues with Procentive being down today? I can't get into the ticketing module to send a ticket and the boss is getting anxious. There were a couple frozen pages initially and then it worked for a while. Now it is down completely.

Can anyone share what system/program you are using for telehealth appointments?  Pros, cons?  Thank you in advance!

Sheryl

We are currently getting error messages when trying to navigate the client module, and when saving or opening appointments, etc.  Anyone else seeing this?  Many staff are reporting it here.