Rejections- Private BCBS

jparker 6 years ago in Billing/Electronic Modules updated 6 years ago 2

We are new to Procentive and I have a couple issues I could use help with. The first one is I am having trouble with rejections from Hennepin Health ,first on was about service codes fixed that resubmitted now the rejection is "service line days" looked at the X-12 summery and claims looked good! Anyone have any insight? Next pertains to BCBS Private claim we as a company do 96% consolidated and Pmaps, when I submitted BCBS paid one day on both claims called them and they said for Private I should not send HPCS  or modifers on a Private claim. does not seem correct to me. Would appreciate any help

We are having this issue with BCBS Commercial plans also.  All of the sudden they do not want HCPS and Modifiers on our commercial plans.  I have sent a couple a couple claims as they told us and hoping the will process correctly.

For Hennepin Health double check the units and dates on the claims.  I had this happen once and the units were over the date span being billed.  

Thanks Jen, I will try it