Wiki Va Premier

[kc-george]

I have a patient who started off her care with Medicaid, and mid pregnancy switched to VA Premier. I am uncertain how to bill these visits. It was a total of 5 visits- I was not sure if I should use the 59425 codes- or just office visits. She then switched back to straight Medicaid.
Thanks.

 

[shannonjackson]

Their provider manual states the following on page 58 and can be found at this link: https://www.vapremier.com/assets/ProviderManual20130709.pdf.

VPHP allows for providers to select from either billing OB care globally or to unbundle those services as care is rendered to the member. Your VPHP contract will stipulate which methodology you should follow; but providers can only select one method

 

[kc-george]

Thank you.

 

[AprilPerry]

when to bill OB package vs drop in w/ sep visits

This is off topic from your question. Can you tell me what length of time does your practice use to determine whether to bill a full OB package or to split out the antepartum visits. We have generally followed the rule that if we see a patient for more than 3 months, deliver, and provide post partum care that we would bill a regular OB package... but there are some questions about this and I cant seem to find any specific info other than for Medicaid.