Wiki Suicide Ideation

[shanhockyfan]

We are having trouble with our pro fee claims getting paid w/ Suicide Ideation as the reason for visit, mostly ER's. The facility claims are getting paid. Does anyone have any ideas on how we can get these paid? Any guidance will be much appreciated. Thank you.

 

[Pam Warren]

What happens a lot of times on diagnosis codes that are mental health related diagnosis is that they require pre-certification, and the claim edits at the payers may not be picking up that this is an ED visit....are you using the correct place of service on your claim? Do you know what diagnosis the facility is using? What reason are you getting for the denial?

 

[shanhockyfan]

The facility side is getting paid but the profee claim is being denied.