O’Brien’s Billing will be closed Wednesday, November 21 through Friday, November 23 and will reopen for normal business hours on Monday, November 26 at 8:30AM. We wish everyone a happy and healthy Thanksgiving!
As you may have noticed, patients with Blue Cross policies out of Massachusetts have recently seen their 90837 claims deny. This is due to their decision to begin enforcing a new, restrictive behavioral health policy, the details of which are included in the .pdf below. In short, they are now capping the payable session lengthRead more about BCBS of Mass Behavioral Health Policy[…]
For those of you currently using Payspan to receive payments from Excellus BCBS, or if you are currently receiving paper checks from Excellus but would like to be paid via direct bank deposit, EFT services will be changing over to Instamed. The registration process is fairly straight-forward, and while you have the option of registeringRead more about Instamed Registration[…]
Effective May 2016, United Behavioral Health (UBH) will no longer provide out-of-network benefit quotes to non-participating providers (or their representatives). Unfortunately, this means that any patients considering using their out-of-network coverage would have to call either the Member Services or Mental Health Services phone number on their card directly to inquire about deductibles, co-insurance, visitRead more about UBH O-O-N Benefit Quotes[…]
I just wanted to summarize the information regarding Beacon’s acquisition of the contract to manage all matters related to mental health treatment for Total Care members. As of 2/1/16, Total Care patients will not have out-of-network benefits, meaning that you must join the Beacon Health Strategies network to provide services to Total Care members (notRead more about Beacon Health/Total Care[…]
O’Brien’s Billing will now be using Virtru Encryption services when sending sensitive documents such as billing reports, EOBs, visit histories, etc. This is a HIPAA-compliant solution that does not require dissemination of unique keys to unlock documents. The software can be added as an extension or plug-in in most email clients, or you can simplyRead more about Virtru Encryption[…]
A.G. Schneiderman Announces Settlement With ValueOptions To End Wrongful Denial Of Mental Health And Substance Abuse Treatment Services Investigation Revealed ValueOptions Denied Mental Health Claims Twice The Rate Of Other Claims, And Addiction Recovery Services Denied Four Times As Often Company Administers Mental Health and Substance Use Disorder Benefits For Major Health Insurance Plans IncludingRead more about Value Options Settlement[…]
The Empire Plan seems to be denying all 2015 claims for patients who are the spouse or dependent of the insured. They are doing so stating that they are requesting confirmation that the patient isn’t eligible for coverage under another insurance carrier. In such cases, the insured would need to contact Value Options to updateRead more about 2015 Empire Plan Denials[…]
Many of you have been receiving denials from Total Care due to a “failure to obtain authorization.” Total Care has not reversed their policy on prior-auths for outpatient mental health services, and these denials are not correct (unless the patient has been seen more than 20 times in a six-month period). If you receive anyRead more about Total Care Denials[…]
The Monroe Plan through Excellus had a recent glitch in which many claims denied as though the patient has become eligible for SSI, indicating that the visits must be billed to Medicaid fee-for-service. They have run an audit to identify such claims and are already having them reprocessed to pay correctly.