Effective May 1, 2021: Updates to Ontrak Program Service Claims and Appeals
Date: 04/16/21
Effective for service dates on and after May 1, 2021, Ontrak program service claims and claim appeals must be submitted to Superior HealthPlan for processing. Providers will be required to file claims and appeals consistent with the provider’s contract with Superior, as specified in Section 10 of Superior’s STAR, CHIP, STAR+PLUS, STAR Health and STAR Kids Provider Manual. To review the manual, please visit Superior's Training and Manuals webpage.
Superior will amend providers’ existing contracts to include provisions for Ontrak program services. In order to receive the specialized rate for these services, providers will be required to submit modifier X2, along with the modifier that identifies the provider type rendering the services, with each Ontrak program service procedural code submitted on a claim(s) for service dates May 1, 2021 and after.
Providers must submit the applicable provider type modifier(s) in the primary modifier position(s) as appropriate:
Modifier | Description |
|---|---|
AH | Clinical Psychologist |
UB | Post-Doc |
UC | LPA |
U9 | PLP |
The X2 modifier must be submitted in the secondary modifier position for billing of Ontrak program services. This modifier is unique for Ontrak program services, and should not be used for any other member billings. Claims will not be reimbursed according to the reimbursement schedule for Ontrak services if not billed correctly.
Please note: Superior reserves the right to perform post payment reviews to validate appropriate billing and reimbursement for these services.
Providers should continue to submit Superior STAR Adult member and STAR+PLUS member Ontrak claims and/or claim appeals for service dates through April 30, 2021 to Ontrak for processing. On and after May 1, 2021, Ontrak will continue to support the Ontrak program referrals for Superior members.
If you have any questions, please contact Superior Provider Services at 1-877-391-5921, or your assigned Account Manager.