Please help!!! I have a BCBS medicare advantage plan client. I just received an auth from Evicore for the SNV. Now the question is how do I bill it? Episodic
or FFS? I have tried both ways (without the auth) and they were denied. If episodic do I put their auth # in the comment area? Any help would be greatly appreciated!
Thanks
KELLY RADER
INSURANCE BILLING SPECIALIST
HENNEPIN HOME HEALTHCARE
763-425-5959 EX. 44
From: billers@list.mnhomecare.org [mailto:billers@list.mnhomecare.org]
On Behalf Of Salin, Tracy
Sent: Wednesday, February 27, 2019 12:53 PM
To: billers@list.mnhomecare.org
Subject: RE: medicare advantage plans
I am pretty good at advantage plans so let me know which ones and my coworker and I can probably help.
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Jennifer Larsen
Sent: Wednesday, February 27, 2019 12:35 PM
To: billers@list.mnhomecare.org
Subject: RE: medicare advantage plans
If any of you end up figuring out these new Advantage plans, please share how you made the magic happen!
😊
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Salin, Tracy
Sent: Wednesday, February 27, 2019 11:39 AM
To: billers@list.mnhomecare.org
Subject: RE: medicare advantage plans
Omg yep… that too. Homecarefrustrations.
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Laura Brown
Sent: Wednesday, February 27, 2019 11:08 AM
To: billers@list.mnhomecare.org
Subject: Re: medicare advantage plans
Had one lady argue about me sending toenail trims to Medicare because they told her that it covered home nursing visits!
On Wed, Feb 27, 2019 at 11:05 AM Salin, Tracy <tsalin1@range.fairview.org> wrote:
Oh yeah…. Poor things. Then they think we are being difficult. Oh my favorite is when they say Medicare covers home health aide… Well not really, not by itself.
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Laura Brown
Sent: Wednesday, February 27, 2019 11:04 AM
To: billers@list.mnhomecare.org
Subject: Re: medicare advantage plans
And for the love of Pete they need to stop telling them that, yes home care is covered without telling them about the home bound status and other restrictions. We get lots of complaints in regards to that from patients.
On Wed, Feb 27, 2019 at 10:59 AM Salin, Tracy <tsalin1@range.fairview.org> wrote:
I get you there. These poor people who don’t work In insurance get so confused, then they get misinformation and struggle to trust information they get from anyone. It is really unfortunate that way.
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Laura Brown
Sent: Wednesday, February 27, 2019 10:56 AM
To: billers@list.mnhomecare.org
Subject: Re: medicare advantage plans
Well, what I meant is it didn't cover any home care anyhow and was very confusing to the patient, and yes it was better payment from Medicare.
On Wed, Feb 27, 2019 at 10:49 AM Salin, Tracy <tsalin1@range.fairview.org> wrote:
Honestly, it wasn’t worthless for home care because you could bill home care under straight Medicare which pays more. I do think the plans that cover only part B are incredibly confusing though. I wish it could just be either you have an advantage plan or you don’t .
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Laura Brown
Sent: Wednesday, February 27, 2019 10:04 AM
To: billers@list.mnhomecare.org
Subject: Re: medicare advantage plans
It was worthless anyhow for home care, so I'm glad it's gone.
On Tue, Feb 26, 2019 at 4:30 PM Jennifer Larsen <jlarsen@gaehc.org> wrote:
I guess the Prime Solutions plan for Medica in 2018 was one of those cost sharing plans that went away in MN effective 12/31/2018.
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Laura Brown
Sent: Tuesday, February 26, 2019 3:42 PM
To: billers@list.mnhomecare.org
Subject: Re: medicare advantage plans
If they have Medica Prime Solutions you need to bill Medicare since Prime Solutions only covers Part B claims. At least that's how it was in 2018.
On Tue, Feb 26, 2019 at 3:35 PM Jennifer Larsen <jlarsen@gaehc.org> wrote:
Every single one of my BCBS and Medica claims have been denied so far.
Medica is denying CO-96, I called them yesterday and was told that the referring physician needs to complete the referral form online at Medica.com. Just so happened we received a new referral for someone who had Medica, I went to their website and was going to complete the referral and the Medica Advantage Plan was not even an option to select to enter a referral. However, with my claims that were denied I was instructed to submit 15 appeals and attach the MD referral/orders. I am about to place another call to Medica and see what answer I get this time.
BCBS, I just spent 2 hours on their website looking for anything I could find on claim submission since customer service couldn’t answer the question as far as episodic or per visit. I billed ours per visit, used T codes originally, they were denied so I submitted corrected claims using G codes, I received back 2 denials yesterday stating that we do not have an authorization, in which we do. The others were denied CO-16, I called customer service and she could not explain to me on 3 separate claims what information was incorrect. So now I wait for another phone call.
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Patti Fladwood
Sent: Tuesday, February 26, 2019 3:06 PM
To: 'billers@list.mnhomecare.org' <billers@list.mnhomecare.org>
Subject: medicare advantage plans
I’m wondering if anyone is having trouble getting paid on the Medica, Healthpartners, and BCBS new advantage plans? Are you billing episodic or per visit? G codes or T codes.
Thank you!
Patti Fladwood
BILLING SUPERVISOR
Optage Homecare, Hospice, and Primary Care
Presbyterian Homes & Services
2845 Hamline Avenue North, Roseville, MN 55113
Tel:(651)631-6198; Email: pfladwood@preshomes.org
Optage® is the home and community services division of Presbyterian Homes & Services.
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Laura Brown
Financial Coordinator
Lake Region Home Health
320-354-5858 phone
888-501-7631 fax
CONFIDENTIALITY NOTICE: This message (including any attachments) may contain confidential client information. The information is intended only for the use of the individual or entity to whom it is addressed. If you're not the addressee or the employee or agent responsible to deliver this e-mail to its intended recipient, you are hereby notified that any review, use, dissemination, distribution, disclosure, copying or taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this communication in error, please notify the sender immediately, delete this message from your computer and ask your network administrator to delete it from any storage or back up files.
--
Laura Brown
Financial Coordinator
Lake Region Home Health
320-354-5858 phone
888-501-7631 fax
--
Laura Brown
Financial Coordinator
Lake Region Home Health
320-354-5858 phone
888-501-7631 fax
--
Laura Brown
Financial Coordinator
Lake Region Home Health
320-354-5858 phone
888-501-7631 fax
--
Laura Brown
Financial Coordinator
Lake Region Home Health
320-354-5858 phone
888-501-7631 fax
CONFIDENTIALITY NOTICE: This message (including any attachments) may contain confidential client information. The information is intended only for the use of the individual or entity
to whom it is addressed. If you're not the addressee or the employee or agent responsible to deliver this e-mail to its intended recipient, you are hereby notified that any review, use, dissemination, distribution, disclosure, copying or taking of any action
in reliance on the contents of this information is strictly prohibited. If you have received this communication in error, please notify the sender immediately, delete this message from your computer and ask your network administrator to delete it from any
storage or back up files.