Author Topic: Keystone First EPSDT claims  (Read 1020 times)

sls

  • Newbie
  • *
  • Posts: 31
Keystone First EPSDT claims
« on: November 07, 2018, 01:33:38 PM »
anyone familiar with the EPSDT billing. I have claims that are denying missing information and following their guidelines they should be ok.  I was wondering if I could pick someones brain to see what we are doing wrong. When I call them they are no help, they just state its missing information.  If you know of a site or have personal experience please let me know. Thanks in advance

Michele

  • Administrator
  • Hero Member
  • *****
  • Posts: 5927
    • Solutions Medical Billing
Re: Keystone First EPSDT claims
« Reply #1 on: November 07, 2018, 05:12:31 PM »
So the denial is just stating "missing information"?  Have you ever had any claims paid?  I would have a paper copy of the one that paid, and compare it side by side to one that is denying. 

If you don't have any that were paid, I would look for the Medicaid provider manual to see what the instructions are.  Since Keystone First is a Medicaid managed health plan, they should follow the Medicaid rules so the provider manual may help. 

If you've tried calling but they are not helpful then you will need to try to find out what's wrong another way.  I'm not sure if you've called more than one time, but it may be that you had an unhelpful rep.  If I get one like that I try back later to get a different rep.

I haven't billed EPSDT myself so I don't have anything specific but that's my ideas.
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

Medical Billing Forum

Re: Keystone First EPSDT claims
« Reply #1 on: November 07, 2018, 05:12:31 PM »