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PrimeWest reimbursement for 90837

Kerri Ono 2 years ago in Billing/Electronic Modules updated by ahuseby 2 years ago 4

Has anyone had success with reimbursement from PrimeWest Insurance and billing 90837 psychotherapy? If so would you be willing to email me the secret to your great success.

We do quite a bit of billing for 90837 code with a lot of our payers including PrimeWest.  But I wouldn't say there is really any secret, as we have never really had any issues billing it and getting reimbursed. 

We have only had success with PrimeWest after receiving prior authorization since we are out-of-network for them. Could this be the issue you are experiencing? 

Hi Emily,

We are OON with PrimeWest.  I have submitted a prior auth request for our other services through their Provider Portal and have successfully received authorization for those services.  However, the 90837 code I was told by a Rep from PrimeWest that we would need to try to obtain payment from Douglas County Social Services for this Targeted Dual Diagnosis Mental Health Case Management.

I'm at a total loss and don't understand this one.

If anyone would be willing to message me where to submit the auth request for 90837 it would be greatly appreciated!

Ahh - we are in network, so that must be the difference then.