facilityvsprofessional

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    Wiki Medicare CMHC Credentialing

    Hello, I work with Mental health practice and facilities. One of my Medicaid only Residential SUD Facilities is now enrolled with Medicare Part B and would like to bill for IOP and PHP services. I cannot find in the Medicare manual that this is covered unless they are a CMHC. I have submitted...
  2. M

    Wiki Insurance company paid facility but denied professional claim

    Has anyone ever had this happen? Insurance company ABC paid the facility for a procedure, but denied professional claim. Several calls have been made to ABC and representatives state the provider office needs to contact the facility for payment. (? What? Really, since when???) ABC says an appeal...
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