Insurance billing - telehealth place of service
None

Hi,

I have been getting denials from Regence the past four weeks. When i called I was told to leave place of service as personal office and use the modifier 95.

I am wondering if i should submit other bills for other insurance companies this way?  Have you heard that if it the Telehealth apt is due to Covid restrictions that we keep place of service as where we would typically meet - and then use the modifier to identify that it is Telehealth.

Any thoughts are appreciated. thank you

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    William Horn

    Hi Carie,

    I just received a denial on one of my pt's insurance submission in which the place of service for telehealth on my Simple Practice generated bill is indicated by (02).

    I am interested in clarification regarding this issue as well.

    Would appreciate hearing from others as well regarding their experience with this issue

     

    Many thanks,

     

    William H.

    Hi Carie,

    I just received a denial on one of my pt's insurance submission in which the place of service for telehealth on my Simple Practice generated bill is indicated by (02).

    I am interested in clarification regarding this issue as well.

    Would appreciate hearing from others as well regarding their experience with this issue

     

    Many thanks,

     

    William H.

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    Patricia B. Jones

    Yes, you need to use the Mod 95 for telehealth. I just do not know how to make this automatic so I do not need to change each claim every time.

    Yes, you need to use the Mod 95 for telehealth. I just do not know how to make this automatic so I do not need to change each claim every time.

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    William Horn

    Patricia,

    Thank you for your response. Do you know how to change it on single claim vs making it automatic?

     

    Patricia,

    Thank you for your response. Do you know how to change it on single claim vs making it automatic?

     

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    Gillian

    Hi Patricia and William, I'd be happy to help. Insurance payers often differ regarding what coding they prefer for Telehealth sessions - some ask that the 02 place of service code is listed, whereas others ask for a GT or 95 modifier. The best source of information for how to code insurance sessions is always the payer. 

     

    To add a modifier automatically to all of a client's sessions, go to Edit on their Overview page, then Billing and Services. At the bottom of the page, you can add a default service and modifier for that service. That way, if different payers require different modifiers, you can customize which modifier is associated with each client. 

    Hi Patricia and William, I'd be happy to help. Insurance payers often differ regarding what coding they prefer for Telehealth sessions - some ask that the 02 place of service code is listed, whereas others ask for a GT or 95 modifier. The best source of information for how to code insurance sessions is always the payer. 

     

    To add a modifier automatically to all of a client's sessions, go to Edit on their Overview page, then Billing and Services. At the bottom of the page, you can add a default service and modifier for that service. That way, if different payers require different modifiers, you can customize which modifier is associated with each client. 

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    Caley O'Dwyer

    Gillian, thanks for your help. When I follow your instructions above I do come to the area at bottom of client "Billing and Services" page, and while I see how to add additional services in general, I don't see a way to add a modifier in particular. For example, I'd like to add the 95 telehealth modifier to a 90834 Psychotherapy, 45 min service but I don't see a way to add that modifier. Should it appear in the "select to add new service" drop down menu? Maybe I'm overlooking it??

    Thanks!!

    Caley 

    Gillian, thanks for your help. When I follow your instructions above I do come to the area at bottom of client "Billing and Services" page, and while I see how to add additional services in general, I don't see a way to add a modifier in particular. For example, I'd like to add the 95 telehealth modifier to a 90834 Psychotherapy, 45 min service but I don't see a way to add that modifier. Should it appear in the "select to add new service" drop down menu? Maybe I'm overlooking it??

    Thanks!!

    Caley 

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    Ayelette R

    Hi Caley,

    I'm happy to clarify this.

    To enable the practice wide option to add default modifiers to a client's profile, go to Settings > Billing and Services > Insurance > select Enable Modifiers for your practice > click Save.

    After that practice wide setting is enabled, you'll see an option on each client's Edit > Billing and Insurance page to add a default service code modifier.

    Hi Caley,

    I'm happy to clarify this.

    To enable the practice wide option to add default modifiers to a client's profile, go to Settings > Billing and Services > Insurance > select Enable Modifiers for your practice > click Save.

    After that practice wide setting is enabled, you'll see an option on each client's Edit > Billing and Insurance page to add a default service code modifier.