Has anyone dealt with Harvard Pilgrim (in the PHCS network). We are being told that they bundle 97530 and 97140. We typically bill 97530 (Therapeutic Activity) with more units. They are paying 97140 (Manual Therapy)- 1 unit and denying 97530 -3 to 4 units. We used the 59 modifier for both services.
We have contacted them- we can escalate no higher than first level supervisor. We have no access to billing or coding, they won't provide a fee schedule, they can't explain why they bundle, they say that they follow medicare guidelines but this is NOT a medicare patient.
Has anyone dealt with this and if so, were you successful in getting paid for each service?