I'm looking for the McKesson Interqual criteria for EIBI that BCBS of MN is referencing in their denials. Does someone have it that they can share or direct me where to find it?  Any guidance would be much appreciated!

We are wondering if any clinic has ever billed Medicare IOP(Intensive Outpatient Program) services, if so what code?  Any information would be helpful.

Hello,

I am trying to set up billing a secondary insurance for our locations -- they have never done this in the past!

I found the settings but after some initial testing it wasn't populating the correct $$$ on the claim(s). There are multiple Yes/No options...help!

Use these settings when a payer is the secondary payer:

Subtract these when computing invoice charge on claim:  

Add these when computing the prior payment:             

Subtract these when calculating the invoice charge:

I am hoping someone can share ideas/best practices on how to get secondary payer billed launched.

Thank you!

Was kicked out of Procentive and unable to get logged back into Procentive for 10 minutes now.  Is anyone else experiencing this too?

We are attempting to bill an IFB (Individual & Family Business) plan that requires the referring provider on the claim. I am having trouble getting this populated. 

Where is this pulled from in Procentive?

Any help is appreciated! 

JRL

We found CPT code 90849- Multiple-family group psychotherapy, however the description states when the patient is present with his or her family, as well as other patients and families for 50 minutes.  Any information provided is appreciated.

Does anyone send in client wellness assessments to Medica after a client has been seen the first or second time? Also do you fill out the form on the Optum website that reports how many complaints you have had for the quarter from Medica clients?

How involved in the Medicare application process?  Our agency is not currently set up as a Medicare provider, but need to move forward on applying.  I'd appreciate your thoughts on how time-consuming the application process is from start to finish.  

How do people show their clients exactly how their copays were applied, when the copay has been turned into a "credit applied"?  Sometimes clients wants to know which copay they missed a long time ago (like in 2016) and sometimes a client wants a list of all copays they've made, showing on which DOS they were allocated, to submit to their flex-spending account. 

In order to make them an actual "list," we have to print out a list of their payments, then for all of the "applied credits," try to figure out which copay date might have been applied to it. This often takes a very long time to research.  What do the rest of you do to show exactly where a copay was allocated, when it has turned into an applied credit?