License Level Modifiers

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JILL FUINI

• December 21, 2020 14:50

Are billers now submitting claims with license specific modifiers

I noticed reduced rates from IBX and Amerihealth Administrators since 10/01?

Such as psychologist HP or AP

Social Worker AJ

Does this start January 2021?

Does it matter what modifier is first telehealth or license specifier?

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  Ruth

  • December 22, 2020 18:07

  Hi Jill, all payers can have specific claim filing rules and requirements. Since we aren't billers, we aren't aware of all of them. You'll want to reach out to the payer to be aware of how to bill them correctly. If you submit a claim and it gets rejected, or denied, we can help by creating a case with our clearinghouse to find more information about the billing requirements necessary to resubmit, or correct the claim. However, insurance payers sometimes limit the amount of information they share with our clearinghouse. So your best bet is to verify specific billing rules with the insurance payer prior to submitting a claim, or after, if claims aren't getting successfully processed and paid for. 

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