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AH AJ and HO Modifiers for Health Partners

Overview 

You can automate these specific modifiers (AH, AJ & HO) to travel on a claim based on staff credentials.  This is specific to the payer Health Partners (HPAMN).  This article will explain how to set this up and handle exceptions for specific codes.
Step 1:  Assign Credentials for Staff
  1. Go to the Staff Module
  2. Double-click to open the staff record
  3. Click on the Role Tab
  4. In the field Credentials (billing), select the billing credential for this staff from the dropdown list

    staff tab billing credentials 11-17-17.png
     
  5. Click Save

Important Note:

  • PsyD will assign a modifier of AH
  • LICSW will assign a modifier of AJ
  • LP will assign a modifier of HO
Step 2:  Set Up Payer
  1. Go to the Payer Module
  2. Double-click to open the Health Partners payer
  3. On the Payer Tab, choose a default setting in Automatically send AH, AJ, and HO modifiers
    • Yes: Automatically send these modifiers for all codes that have the appropriate credentials.
    • No:  Do not automatically send these modifiers for all codes that have the appropriate credentials.
    • If this depends on the code see the next section -> Code Specific.

      payer setup ah aj ho modifiers 11-17-17.png
       
Code Specific

Use this additional setting if you need to over-ride the default because a specific code does not follow that rule.

  1. Click on the Rates tab
  2. Click on the Codes Sub-tab
  3. Find the line for that code and scroll to the far right to select your choice in the column Automatically send AH, AJ, and HO modifiers.

    payer setup rates codes tab ah aj ho 11-17-17.png

     
  4. Click Save
Additional Resources

Verify Modifiers Before Sending Claims

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