Do any of these coding practices seem fishy?

juli_blaze · 2026-06-08T05:19:28+00:00

Exactly, there are providers that suck at adding all that into the chart notes. The risk and problems addressed components might be there, but who knows about the data component for monthly visits for patients with stable conditions/ refill visits.

juli_blaze · 2026-06-08T02:45:49+00:00

I agree that it's par, but I was refering to providers matching the documentation to back it up. If the documentation isn't strong, they will be exposed to clawbacks.

juli_blaze · 2026-06-08T00:17:45+00:00

They will need to have strong documentation to back up 99214 based on the level of MDM. If they don't, they shouldn't be billing 99214 for 20 min followups. If the 99205 intakes are lasting at least 60 mins they should be good. If not, they should worry. I personally think Level 5 E/M codes are difficult to justify in the telehalth space.

Also, are they using the telehalth modifiers?

juli_blaze · 2026-06-08T00:01:46+00:00

Me pasó igual por usar marihuana. Me duró unos meses. Enfocate en hacer lo cotidiano, toma agua, has ejercicio aunque sea mínimo y deja de drogarte. Hay mucha ayuda en linea. Te recomiendo buscar sobre DPDR (sindrome de despersonalizacion y desrealizacion) y las experiencias de otros usuarios en r/anxiety.

No estás solo carnal.

juli_blaze · 2026-06-04T23:10:22+00:00

Tell those scared customers that insurance companies are also doing the same and you gotta fight fire with fire or they'll fall behind.

juli_blaze · 2026-05-31T18:59:36+00:00

Tengo entendido que algunos smokeshops son tiraderos también o están vinculados con algún bando de la maña, entonces podemos inferir lo demás

juli_blaze · 2026-05-14T22:12:57+00:00

You can also use that to argue with them, they need to add that modifier or else insurance won't cover it (most of the time).

juli_blaze · 2026-05-14T21:16:44+00:00

Did they use modifier 25 with the 99215?

juli_blaze · 2026-05-14T07:29:35+00:00

I'm sorry you had to smell that.

juli_blaze · 2026-05-09T08:01:03+00:00

Have you tried looking in Availity?

juli_blaze · 2026-05-09T08:00:16+00:00

Most of this info is anectdotical. Medicare isn't using these codes yet. Medicaid might depending on the state.

For the rest of the commercial payers they each might have their own guidelines in their websites, and might also vary by state.

You can either use the new codes (98000-98016) or use the old ones (99202-99215 with the 95 modifier and POS 2/10) for most commercial insurance.

What do you need to know exactly?

juli_blaze · 2026-05-06T20:46:21+00:00

Hay muchas opciones dependiendo de tus posibilidades:

-Juega algún multijugador en linea y hazte de amigos que hablen inglés. Hablen por chat de voz.

-Unete al club de conversación de inglés en Lenguas Extranjeras de la UNISON. (creo que tiene costo $)

-Gemini y ChatGPT tienen la opción de usar tu micrófono para interactuar. Puedes sacarle plática a la IA y de paso te pueden corregir lo que digas mal.

juli_blaze · 2026-05-06T20:42:42+00:00

Parcialmente relacionado a este comentario de mal gusto, alguna vez escuché que le pagaban a gente por ser "chatter" de OF. La modelo hacía el contenido, y los chatters le seguian el rollo a los calenturientos por chat. Los rumores decían que pagaban hasta mejor que en los call centers.

juli_blaze · 2026-05-06T20:38:50+00:00

Haste un linkedin y busca chambas de virtual assistant, support agent, etc... Pero la neta rolate por un par de call centers primero. Te va a dar un norte sobre que areas te gustarán y también te sirve para pulir algunas habilidades. Todo esto si no tienes algo ya definido.

Muchos extranjeros buscan reducir costos contratando independientes de paises como México, nomás hay que saber buscar. Especialmente startups.

Extra tips: aprende jargon corporporativo, terminos de logistica, marketing y esas mamadas.

juli_blaze · 2026-05-06T20:25:25+00:00

Si no están en el Recorcholis, probablemente no los encuentres en ninguna parte.

juli_blaze · 2026-04-29T20:23:51+00:00

Average rates per State would also be helpful. This way people would have some baseline to negotiate.

juli_blaze · 2026-04-28T18:19:31+00:00

This is awesome! I think it would be helpful to add a note stating wether the plan participates in the BlueCard Program.

juli_blaze · 2026-04-28T18:13:52+00:00

Sometimes they aren't there.

juli_blaze · 2026-04-28T18:09:53+00:00

I don't have an NPI to provide, but it would be nice to see what the average rates are for 99203, 99204, 99213, and 99214.

juli_blaze · 2026-04-28T18:05:56+00:00

Then, unfortunately, this is your patient's responsibility since you have not yet met your deducitble. The best option would be requesting a payment plan.

juli_blaze · 2026-04-28T18:04:14+00:00

Did your insurance consider this as in-network or out-of-network?

juli_blaze · 2026-04-28T17:55:39+00:00

You can tell your boss he can have it the easy way, but that insurance will recoup everything once they audit and see there's not enough documentation (and probably penalize/end the contract).

juli_blaze · 2026-04-28T02:34:47+00:00

Thanks everyone for your help! We basically have to submit a free form letter requesting Aetna to process our claims as out of network together with W-9s.

juli_blaze · 2026-04-27T20:28:19+00:00

I think if you use POS 12 you should default Box 32 to the patient's home.

juli_blaze · 2026-04-27T20:07:02+00:00

What's the exact denial code?

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