Have questions about claims? We’ve got answers.
- The red ink we require allows our scanners to create a "cleaner" image of claims which is easier and faster to process with data capture automation software and increases our accuracy and timeliness of claims adjudication.
- MHN cannot accept non-standard claim forms or photocopied claims forms because those do not allow our scanners to create the clean image necessary to complete claim adjudication.
- If you receive a rejection from MHN for this reason, you will be given details on the requirements and the need to resubmit.
- Alternately, you can submit claims electronically to avoid this requirement.
As a facility offering Intensive Outpatient or Partial Hospitalization Program services (IOP/PHP) you may have received notice of the need to submit itemized details for the services provided and billed. You do not need to submit a dispute or appeal to provide MHN the additional information; just re-submit the claim – The additional information needed is: a breakdown of all services rendered, the costs, and all CPT or HCPCS codes.
Please review MHN’s policy regarding revenue codes for out-of-network facilities billing for IOP/PHP services below:
- Substance Use Disorder IOP/PHP Revenue codes 905, 906, 910-913 are not payable codes for out-of-network facilities. The only payable revenue codes are 043X, 0900, 0904, 0914-0916, 0918 and 0942.
- Mental Health IOP/PHP Revenue codes 905, 912 and 913 are the only payable revenue codes for out-of-network facilities.
If you are a contracted provider and received an overpayment /recoupment letter, please refund MHN as requested or else the funds owed may be offset against future payments. Please do not request an offset of the overpayment because the offset process is automated.
If you are a non-contracted provider and received an overpayment /recoupment letter, please refund MHN as requested. MHN will not offset the funds owed against future payments.
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