Apply Copays to the Correct CPT codes when grouped in same invoice (i.e. psychological testing codes)
Psychological Testing uses two sets of CPT codes 96130/96131 or 96136/96137 with "30" or "36" being the first unit of the day and "31" or "37" being all subsequent units provided on the same day. These codes must be grouped into a single invoice when billing to avoid denials for duplicate codes. Currently, the system automatically and incorrectly applies the co-pay to the top line item of an invoice which will always be the "31" or "37" code as they are billed after the "30" or "36" code. This is incorrect, as the co-pay should be applied to the "30" or "36". This causes extra work on the RCM team to manually update all invoices to move the co-pay collected and client amount due to the correct line item. It also corrects incorrect client ledgers as it will state a co-pay is due for each CPT code.
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Albert Knapp commented
I have been talking to all tiers of support about this as well as SR RCM managers and VPs of RCM and Customer Success. This is a known issue and has been going on for way to long. To allow a system to bill incorrectly is unethical, and I do not understand why this has been occurring for so long.