Has anyone lately had trouble getting their new contracted rates updated in UBH's system.  We have a contract effective 8/1/2017 and our claims still are not being paid correctly

Is anyone having trouble with UBH denying claims for no authorization when no authorization is needed?

Has anyone else received their letter/invoice from BCBS in regards to the overpayment of Medicaid claims that were paid at a CMHC level, incorrectly? And is so, what is your plan to identify and "internally" re-process ALL of the affected claims?

How does your organization track which clients have had their insurance benefits verified versus those that have not been verified for outpatient appointments?  (So all administrative staff can "see" this upon intake in procentive-specifically the Appointment Module)

Our agency is starting to use e-prescribing and have a few questions. 

Does anyone use e-prescribing? How have you liked it? Are you able to prescribe  C2 medications on Dr First? How does it work to send a lab order? 

Thank you 

Teresa

Is anyone else missing ERA's from BCBS from this past weekend? I normally get some decent sized ERAs and have not yet received BCBS commercial and only a smaller than normal Blue Plus.

Has anyone else closed any charts today and ended up entering a date of death? I am wondering when Procentive added the "Date of Death" box on the Client Tab of the Client Module? It is in the same place where the "Date file closed" used to be. Ended up putting in a death date for a child this morning, by accident. I did not see a notification of this change. Did anyone else? Should I be looking somewhere for these updates that I appear to be missing? Thank you for any help!

It has been brought to our attention that BCBS of Minnesota (ID SB720) has changed their requirements and are now requiring R&B codes to send before treatment codes on claims. As you may have noticed, all claims for R&B and treatment sent to BCBS of MN are being denied but are not given a denial reason. 

Thank you to all who have sent tickets relating to this issue. Through these tickets, and calls from our staff to the payer, we have succeeded in identifying this issue.  In the interest of saving your time, there is no need to call the payer on this issue as we are actively working on a resolution.

We are aware that this is a critical issue so please watch this post for an update. We will have more information available tomorrow (11/09/2017)

Thank you,

Care Team 

I was wondering if anyone else was having the same problem and if there were any suggestions on our end for this. Recently we have had two different kids have skills (H2014) deny because according to the representatives at Blue Cross PMAP "there is a waiver that the policyholder did not sign."

What does this mean? Who would then be responsible? Since it is a PMAP plan and the child has active MA, we are unable to bill the parents for not signing a waiver. If they did in-fact not sign a waiver, why would only the skills deny and not other IOP services that the child was receiving?

If a client has commercial insurance as primary, but MA as secondary, do you do MA-required charting, ie full DA, treatment plans every 3 months...?