CPT Codes
What is the Methadone CPT code?
H0020
Where are the notes placed in SAMMS?
Payment tab - billing note
Where are the OBOT fee schedules housed?
In the OBOT teams channel
What portals are mainly used for checking eligibility?
Verify Tx and Availity
Which line of business do you always obtain office visit benefits for?
OBOT
What is the OBOT Optum Commercial CPT Code?
H0047
What EMR Systems are used for OTP?
SAMMS and Methasoft
How do you access the SAMMS fee schedule
Select Reports, SAMMS reports, Custom Reports, Search for Fee schedule export, Identify your region, View report
What portal is used to verify Medicare Coverage?
Noridian
Which line of business use H0033 for Buprenorphine?
OTP
What are the three commercial payers that use G codes in OBOT?
Aetna, Humana, Anthem OH and KY
What EMR systems is used for OBOT?
KIPU
BONUS - EPIC
Where are the training resources housed for insurance verification?
In the Insurance Verification Teams Channel
Where do you look in Verify Tx to confirm carve outs?
In the VOB Details section under Additional Payers
Which line of business do you obtain Mental Health and Substance Abuse benefits for?
Both - OTP and OBOT
What payers use G-Codes in OTP?
Aetna, Humana, Medicare Adv Plans, Nebraska Medicaid, Wellsense / Carelon Medicaid Massachusetts
How are flags added in KIPU?
Select flag at the top of the screen
Where can you find the billing POS for OTP?
On the SAMMS Fee Schedule
What benefit should you obtain on the portal for OBOT?
Office Visit Benefit
Which line of business does Anthem OH and KY take G codes?
OBOT
What CPT Codes are used for all OBOT commercial payer that are NOT included in a bundle?
99204, 99214,99213, 80305, 90837
What steps do you take to clear the eligibility queue?
Enter the Eligibility queue, open up a line item, identify if the patient has active coverage and/or fix the payer set up within the account, add notes and flags if needed, and post a response.
Who do you reach out to for fees and payers to be added in the system?
RCM Integrations
Where do you find Part C information in Noridian?
Health Maintenance Organization/ Medicare Advantage (HMO/MA) Benefit Information Section
Which line of business use G2067 and G2068?
OTP