Fix for those seeing rejections while using the 02 Place of Service.
A claims processing fix related to telehealth claims was implemented at 5:00 PDT on Friday (3/20). Now that this change has been implemented, if you saw a rejection with the specification "Claim level facility information should only be sent when either the NPI or address differs from the Biller information”, all you will need to do is resubmit those claims.
Sending claims batches with different Places of Service
For those sending through claims with a combination of Places of Service (11 and 02 for example), we had been advising customers to send those through in different batches to avoid rejection in ClaimsConnect. An alternative solution is that you can choose to send them through together if you turn off Place of Service validation in ClaimsConnect:
- In Claims Connect click on the Settings tab at the top - ANSI Edits tab - in the Service box uncheck Place Of Service - Click on OK
This will allow these claims to go through. If you experience any new types of rejections after making this change, reach out to Support to help resolve.
How do I submit billing for telehealth delivery of care to my clients?
CMS just gave the following correction in their guidance for Medicare claims (full article here):
"Building on prior action to expand reimbursement for telehealth services to Medicare beneficiaries, CMS will now allow for more than 80 additional services to be furnished via telehealth. When billing professional claims for all telehealth services with dates of services on or after March 1, 2020, and for the duration of the Public Health Emergency (PHE), bill with:
- Place of Service (POS) equal to what it would have been had the service been furnished in-person
- Modifier 95, indicating that the service rendered was actually performed via telehealth"
The guidance above is for Medicare clients only. For private insurance we always recommend you verify with your payer how they would like you to complete the coding.
is there any documentation on how to create a new Place of Service and bill?
You can review this series of videos to step you through adding a new Place of Service and creating a session:
First, how to add a new Place of Service.
Second, how to add a service code with telehealth values
Third, how to create a telehealth session using these new values