u/beanzkitty

Hello everyone!

I am new to this subreddit as well as medical coding/billing. I operate a behavioral health practice and recently began the process of contracting with Tri-West. I have heard that Vets must get a referral for Detox and Residential levels of care but cannot find additional information as it pertains to PHP and IOP. I have emailed our contracting representative and have been unable to get a response.

Does anyone have experience billing Tri-West for these services (H0015,H0016,S9480)? It would be very helpful to gain some more insight into the authorization process as well as reimbursement. Our contract simply states that we will be reimbursed 75% of billed charges.