General Category > New!

Mental Health Billing Nightmare!!

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rdmoore2003:
sportsmom,  this is a nightmare!  so far, Tricare South is the only one that is going through and reprocessing claims that are denying for this reason.   Yes it does take up alot of time to contact these carriers and have them reprocess claims correctly.  Not sure what type of provider you bill/code for?  Some are having more issues than others.

PMRNC:
What carriers specifically? I'm not having any problems at all so far.. KNOCK WOOD.

barb2512:
I am only having problems with Aetna Medicaid and Tricare in Texas. All my other insurance companies are processing. And so far, only BCBS of Texas has lowered the rate for the shorter appointment duration. They were paying 84.95 for 90806 and 80.53 for 90834.

PsychBiller:
In GA - Medicaid are denying ALL claims and say that it may be June before they have their system updated, on top of that their system threw a glitch and terminated all contracts for Psychologists!!

Other insurers denying for the new 90834 code are BCBS (GA) and Tricare.  I have not been able to get anything to process yet for Medicare... but this may just because they are being super slow! (I hope!!).

PMRNC:
I HAVE one Tricare patient but it's an EAP case we had auth and services were paid. From what I understand MHN rates right now are the same as last year for the new codes.   If your provider is authorized to use the E/M codes (prescriber) total reimbursement is going to be a little higher.   Here's what I have for MHN.  I had a client in NJ who billed them quite a lot and they can be a bit of a pain <g>  https://www.mhn.com/static/pdfs/CPT_FAQ_12062012_FINAL.pdf

I am so glad I don't bill Tricare because their information for providers on their website is so out of date!! They had a great fee schedule look up but when I revisited (after a long time NOT visiting) all the codes are so outdated!!  And this is for our military????   :o :o :o :o :o >:( >:( >:(

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