Ucare Splitting Room & Board and Treatment Line - Can't send!

Jenna 2 years ago in Billing/Electronic Modules updated by sadie twite 2 years ago 4


Our Ucare claims are splitting room and board and treatment apart and we cannot figure out why (also have a crisis ticket in but wanted to ask here ) Has anyone had Procentive system do this and be able to figure out why? 

Auths are in right, all things match as needed ...


Fun fact, we stopped sending the room & board line to Ucare and just send the Treatment line. I send the R&B claim directly to MNITS. This is for code H2036 and H0019 even. 

Otherwise, I'm sure it's in the payer setting to combine codes in the claim rules tab. Check the Place of Service, make sure the auth numbers are the exact same, staff on both lines are the same or settings reflect correctly. 

I hope this is helpful. 

LaVonne, how long have you been sending the treatment without the room & board? And have you successfully been getting paid for the treatment?

2+ years and I do that for most PMAP's. Commercial payers still need both lines as well as Health Partners and UHC/Medica/ UBH payers. 

Thank you for this information. Just to clarify, are you saying HP and Optum PMAPs are the ones that still want both lines?