Author Topic: Substance Abuse Facility Billing  (Read 1955 times)

psychlady2015

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Substance Abuse Facility Billing
« on: November 12, 2015, 12:23:41 PM »
HI, we are having trouble with BCBS of Florida processing our individual and group sessions.  We bill on a UB 04 because we area facility and they deny stating send it on a CMS 1500 then we send it and they deny it again saying UB04.    Help we have tried everything and they keep denying.   

PMRNC

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Re: Substance Abuse Facility Billing
« Reply #1 on: November 13, 2015, 02:19:45 PM »
Quote
We bill on a UB 04 because we area facility and they deny stating send it on a CMS 1500 then we send it and they deny it again saying UB04.    Help we have tried everything and they keep denying.   

Your professional fees go on a CMS-1500
Your facility fees go on the UB.

You cannot bill both on either form together.
Linda Walker
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Michele

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Re: Substance Abuse Facility Billing
« Reply #2 on: November 14, 2015, 01:24:37 PM »
Have you tried contacting your provider rep for BCBS?  If you are set up in their system as a facility then the claims have to go on the UB04.  We had a client like this in NY.   Because they were classified as a facility BCBS required that the claims be filed on a UB04, even though they were professional fees for individual and group sessions.  You must find out how you are set up with BCBS.  Maybe they have something wrong in their provider files.
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psychlady2015

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Re: Substance Abuse Facility Billing
« Reply #3 on: November 17, 2015, 12:33:58 PM »
I k now we are correct in the BCBS system, however we used to bill 90834 with rev code 914 or 900 and 90853 with a 915, things have changed and it seems they are requireing a 919 rev code can anyone confirm?


Thank you.......

Michele

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Re: Substance Abuse Facility Billing
« Reply #4 on: November 17, 2015, 06:23:48 PM »
I would ask them if they have something in writing to show that.  919 is for crisis intervention and that doesn't really seem to match what you are describing.
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amr_1024

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Re: Substance Abuse Facility Billing
« Reply #5 on: November 19, 2015, 03:59:34 PM »
what type of bill are you using?