Author Topic: EAP Billing  (Read 5315 times)

melissa_2004

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EAP Billing
« on: May 17, 2010, 01:47:57 PM »
Does anyone currently bill EAP?  Specifically billing an EAP company known as Bensinger Dupont & Associates?  Looking for tips and pointers.

Thanks...

PMRNC

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Re: EAP Billing
« Reply #1 on: May 17, 2010, 06:10:39 PM »
EAP works differently with each one. It's an "additional" benefit. One pointer for ALL EAP's is to make absolutely certain you keep a separate file for EAP visits, the reasoning behind it is that it's a complete and separate benefit employers give employees and is STRICTLY confidential. Even the Major Med carrier will not be able to give you information on EAP's, eligibility, etc because one does not know about the other. 99% of the time there are no copay's or coinsurance. EAP's usually have a max per incident OR per patient/annually. Again, they are all different, best to get the guidelines for filing and authorizations via the EAP carrier.
Linda Walker
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melissa_2004

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Re: EAP Billing
« Reply #2 on: May 19, 2010, 12:23:18 PM »
Thanks Linda...

Jdmontee

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Re: EAP Billing
« Reply #3 on: May 22, 2010, 01:30:20 PM »
I bill lots of EAP's as we provider mental health billing.  EAP's are always a seperate entity from other services.  They will require a seperate auth so as Linda stated you must track the EAP seperately.  Also, Cigna Behavioral EAP's are billed using a 99404 proceedure code otherwise they will process as a normal mental health visit.  Alot of carriers require the provider to close out the EAP case with the insurance company once EAP is complete.

Just some other tips!

Joannd

Medical Billing Forum

Re: EAP Billing
« Reply #3 on: May 22, 2010, 01:30:20 PM »