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UHC-PMAP

sadie twite 4 months ago in Payments/ERA Modules updated by dsalazar 3 weeks ago 4

Has anyone been successful in getting paid from UHC-PMAP for residential treatment and SUD outpatient services? We are getting conflicting information on how they want us to bill residential treatment so I would love to hear what form and what codes you are billing especially if you are a 1115 waiver provider. Thank you in advance!

We don't bill for residential tx but after not being paid for a while, I finally called UHC PMAP to find out they actually were paying claims.  Funds were being deposited electronically but we were not receiving the ERAs in Procentive.  I had to log into OptumPay to get the remit for the payments.  I did contact Procentive to find out what was the problem and we just received our first ERA last week.  The payer is UHC of Illinois.  

I'm curious if this ever got resolved. We haven't been paid for anything except for housing stabilization services since they became PMAP. We're getting authorizations for residential services but no payments for res or outpatient.

We needed to get a separate contract.  Our UHC contract didn't cover the UHC PMAP claims.