When billing the new Medica Advantage Plan, are you including the HIPPS code on the claim even though you are not billing episodically?

 

Thank you,

Marnie

Lakewood Health System Home Care

 

From: billers@list.mnhomecare.org [mailto:billers@list.mnhomecare.org] On Behalf Of Muench, Stacie J
Sent: Thursday, May 02, 2019 5:11 PM
To: 'billers@list.mnhomecare.org'
Cc: Jenny Ammons
Subject: Re: Medica Medicare Advantage Plan

 

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I agree.  There has been so many billing changes since the beginning of the year- it must be a record. I haven't seen these many changes in one year. 

 

 

 


From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> on behalf of Jennifer Larsen <jlarsen@gaehc.org>
Sent: Thursday, May 2, 2019 5:01:50 PM
To: 'billers@list.mnhomecare.org'
Cc: Jenny Ammons
Subject: Re: Medica Medicare Advantage Plan

 

WARNING: This email originated outside of Essentia Health. DO NOT CLICK links or attachments unless you recognize the sender and know the content is safe.

I just received a fee schedule yesterday from our rep and yes it is billed in 15 minute increments. And the new reimbursement is pretty good. Today I have been working on re-billing our claims, super fun considering its 3 months worth of claims. UGH.

 

Yesterday I had a very lengthy call with Medica customer service because we received a remit for some March charges and even though they paid on 1 G code per claim, I knew it was incorrect. She stated that the customer service reps just found out about this issue on March 28th and per the email she read to me, this issue is impacting all home health agencies, it also impacts all T, S and G codes billed by home health. Medica has ran a report to capture all the impacted providers and they are in the process of re-processing all claims under the correct fee schedule. Which will take an additional 30-60 days and when it does get paid, it will still be incorrect if you didn't bill by 15 minute increments.

 

Whose ready for PDGM. These changes have surely made my brain hurt this year.


From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> on behalf of Patti Fladwood <pfladwood@preshomes.org>
Sent: Thursday, May 2, 2019 4:34:09 PM
To: 'billers@list.mnhomecare.org'
Cc: Jenny Ammons
Subject: RE: Medica Medicare Advantage Plan

 

We have just gotten “another” final word on how they are paying—not episodically, but with the G codes that they will be paying in 15 minute increments.  We have asked for clarification from our contract rep.

 

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.

 

optage

"This electronic mail transmission may contain confidential health information that is protected by law. It is not intended for transmission to, or receipt by, any unauthorized persons. If you have received this electronic mail transmission in error, please shred it, and notify the sender by reply electronic mail transmission so that our records can be corrected."

 

 

From: billers@list.mnhomecare.org [mailto:billers@list.mnhomecare.org] On Behalf Of Marnie Pogreba
Sent: Thursday, May 2, 2019 4:26 PM
To: 'billers@list.mnhomecare.org'
Subject: Medica Medicare Advantage Plan

 

Hello,

 

I was hoping that someone might have had some success in billing the new Medica Medicare Advantage Plan.  I cannot get a clear answer from Medica if we should bill per month or episodic.   I billed monthly but we were not reimbursed correctly, when I called they just asked me what our Medicare allowable was so they could research the payment which makes me think I should void my claims and bill episodic.

 

Any advice would be appreciated.

 

Thank you.

 

Marnie

Lakewood Health System Home Care

 

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