Wiki Secondary Reimbursement

[apearson10]

Hi,
In need of assistance please ... Our Anthem PPO plan requires billing codes 0364T, 0365T, 0368T and 0369T for BHT (Behavioral Health Therapy). The secondary plan is Anthem Medi-Cal which uses/recognizes only 'H' codes ie: H2019, H0032, H2012, H0046 etc for BHT. How do I bill the secondary for co-pays and deductibles when the plans recognize two different sets of codes? Thank you in advance

 

[joecorinn]

You would have to generate a new claim using the 'H' codes that Anthem Medi-Cal recognizes. These should be equivalent to the codes that you billed to the primary insurance. Send this corrected claim with the primary EOB to Anthem Medi-Cal