Clinical Trainee/Incident to Billing

Tammy 11 months ago in Billing/Electronic Modules updated 11 months ago 4

We are trying to confirm which commercial health plans allow clinical trainees (incident to billing).  We've confirmed that most BCBS commercial plans and all Pref One plans allow it.  Has anyone had success with Healthpartners-commercial?  I can't get a confirmation from that insurance network.  We are billing Hpart-PMAP without any issues.  Any current information for clinical trainees would be appreciated.  Thank you.

We have used clinical trainee billing using a "billing supervisor" with the following payers for several years now:

1) BCBS ND, allows, but they will only allow LAPC, LAMFT to do this type of work  

2) BCBS MN, allows, but have to use U7 modifier on claim 

3) Health Partners Comm - allows 

4) Magellan - allows, but have to use U7 modifier on claim

5) Optum (and all subsidiaries)  - allows but therapist has to have at least Master's degree

6) Preferred One - allows but have to use U7 modifier on claim

This is very helpful.  We were told by our Optum Network Manager that clinical trainees are not allowed so maybe it is because of our specific contract.  I will dig into this some more to see if I can get anything changed.  

One last question, do you use the U7 modifier for HealthPartners commercial? 

Thanks so much for taking the time to respond.

We do also have a supervisory addendum for our Optum contract, so that might be way we are able to and someone else might not be based on contracts.    HP-Comm, no, it does not require us to bill using U7 modifer. 

I really appreciate all of this information.