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How to bypass a primary payer that doesn't allow clinical supervision

Stephanie B 4 years ago in Billing/Electronic Modules updated by crystalp 4 years ago 3

A client is seeing a clinically supervised therapist. The client's primary insurance does NOT allow clinically supervised therapists but their secondary does. How do I bill?

You will still need to bill the primary insurance to get the denial, and then submit to secondary along with the COB informaiton

My problem is that even though I am billing with the U7 modifier, the primary is still paying for it- not denying it.

Good question. We have that issue to. We bill our trainees with modifiers and often times the payers that say they DON'T reimburse clinical trainees...do still process/pay the claims.