So I am finding authorizations for Blue Plus but they have strange procedure codes AHSN - UMSG for skilled nursing and AHHA-USMG for home health aide, but no dollar amounts or REV codes. Does anyone know how we are supposed to be billing HHA and SN? Do we enter the same dollar amount as before? Do we have to change T1030 to  AHSN-UMSG? I am very confused, sorry, also I don't see any authorization numbers.

Thank you Amanda!

 

Tina Tomberlin

 

From: billers@list.mnhomecare.org [mailto:billers@list.mnhomecare.org] On Behalf Of Amanda Szumowski
Sent: Thursday, February 14, 2019 2:09 PM
To: billers@list.mnhomecare.org
Subject: RE: Blue Plus MSHO/EW

 

https://www.bluecrossmn.com/healthy/public/portalcomponents/PublicContentServlet?contentId=P11GA_16938159

I just found this link…it is an older BCBS bulletin, but might get you somewhere…

 

Last summer (before all these changes), I went to the BCBS billing seminar and found out that we have a BCBS Home Care contact that we can email for Home Care questions that the call center can’t or isn’t answering for you. His title is Network Management Consultant.  Hopefully this guy can help you out with questions…FYI, sometimes it takes him a few days/weeks to get back to you as I would assume he is pretty busy…also, be as specific as you can in your email so that he doesn’t have to come back at you with questions.

Richard “Rick” Culler

Richard.Culler@bluecrossmn.com

 

Good luck to us all!

 

Amanda

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Marnie Pogreba
Sent: Thursday, February 14, 2019 1:38 PM
To: 'billers@list.mnhomecare.org' <billers@list.mnhomecare.org>
Subject: RE: Blue Plus MSHO/EW

 

We have a patient that has Blue Plus PMAP, I faxed an authorization request to Amerigroup, they have a fax # just for Home Care, it is 844-480-6841.  We received the authorization the next day.  They say they do not back date.  I am nervous about these waiver patients with SNV and HHA that go through the County and if the County really is the one who needs to make the request or if we do .  It is terrible that we cannot get any clear answers from the Insurance.

 

We also have a patient that has BCBS Medicare Advantage, I faxed that authorization request to evicore, they give you up to 14 days I believe to make your request, and we received that authorization the next day. 

 

I honestly cannot remember how I even found the forms, but they are BCBS forms.  I would attach them, but I have them filled out with our information for my master copy.

 

Marnie

 

From: billers@list.mnhomecare.org [mailto:billers@list.mnhomecare.org] On Behalf Of Tina Tomberlin
Sent: Thursday, February 14, 2019 12:26 PM
To: billers@list.mnhomecare.org
Subject: RE: Blue Plus MSHO/EW

 

I am starting to think that too.

 

Tina Tomberlin

 

From: billers@list.mnhomecare.org [mailto:billers@list.mnhomecare.org] On Behalf Of Salin, Tracy
Sent: Thursday, February 14, 2019 11:07 AM
To: billers@list.mnhomecare.org
Subject: RE: Blue Plus MSHO/EW

 

I honestly don’t think even Blue Cross knows…..

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Tina Tomberlin
Sent: Thursday, February 14, 2019 11:05 AM
To: billers@list.mnhomecare.org
Subject: RE: Blue Plus MSHO/EW

 

Does anyone here know what the SNV and/or  HHA authorization threshold is for Blue Plus/MA, without a waiver?

 

I have searched the web site and also called the help desk, and was told no authorization is required for SNV or HHA.  For some reason this just feels wrong and wondering if anyone has any insight on this question.

 

Tina Tomberlin

Mille Lacs Health System

Home Care / Hospice

Direct - 320-532-2807

Fax – 320-532-4325

ttomberlin@mlhealth.org

 

 

From: billers@list.mnhomecare.org [mailto:billers@list.mnhomecare.org] On Behalf Of Salin, Tracy
Sent: Thursday, February 14, 2019 8:01 AM
To: billers@list.mnhomecare.org
Subject: RE: Blue Plus MSHO/EW

 

All I really know is that Blue Plus is going to be managed by amerisomething. So auths are ending in March so apparently there will be a change. We are just a lost here.

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Marnie Pogreba
Sent: Wednesday, February 13, 2019 5:03 PM
To: 'billers@list.mnhomecare.org' <billers@list.mnhomecare.org>
Subject: Blue Plus MSHO/EW

 

Hello,

 

I am wondering how and if you are getting your authorizations when a patient has Blue Plus MSHO with Elderly Waiver.  I found my Homemaker authorizations in Availity just fine.  However the authorizations I am expecting for Skilled Nurse visits and Home Health Aide visits are not in there.  The strange thing is, I am finding an authorization for Home Care for the right dates and mostly the right units but not for the correct CPT code.

 

This is all so confusing and the County Care Coordinators that I work with are just as confused.  There seems to be no clear information on this and part of me is wondering if I am supposed to request my own authorization for the SN and HHA rather than the County.

 

I would like to know if anyone else knows something more or if you have had success getting your SN and HHA authorizations for patients on Blue Plus MSHO with an Elderly Waiver. 

 

Thank you,

Marnie

Lakewood Health System Home Care

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in reliance on the contents of this information is strictly prohibited.  If you have
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and destroy all copies of this communication, including all attachments.

Confidentiality Notice: This e-mail and any attachment may contain confidential information that is legally privileged. This information is intended only for the use of the individual or entity named above. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulation. If you are not the intended recipient, you are hereby notified any disclosure, copying, distribution or action taken in reliance on the contents of these documents is strictly prohibited. If you have received this transmission in error, please notify the sender immediately, reply to this transmission and delete these documents.