It does not look to be that (I am still waiting for the full remit) however one claim was 6% less, the other is over 20% less than fee schedule.

 

 

Do they take 2% sequestration for Medicare advantage plans?

 

 

 

 

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We, also, got paid a little less than the fee schedule states.

 

 

 

We billed per their fee schedule, so the total billed is what they should be paying. I checked on-line and the claim in their system has not finalized yet but it states an amount, which is less than what we billed. I called an was told to wait for it to finalize but we were just checking to see if anyone else has had this issue?

 

 

I thought they were going to pay according to your fee schedule for every 15 minutes

 

 

 

 

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I have not billed anything lower than 4 units for an hour visit, yet.  I do not know if they will adjust down if you bill 3 units. 

 

 

 

What were you reimbursed per 15min?  Did they adjust down?

 

 

 

Good morning.  We billed G0299 per 15 minute increment per date of service and were paid.  We did not include the HIPPS code. 

 

 

 

Did they tell you whether the HIPPS code was necessary??

 

 

 

 

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Lynette,

 

We also got paid 1 unit, on 1 code per claim and the rest of the G codes were denied. I attended a Medica Webinar today, and I posed the question to them about sending corrected claims now or wait until they finish their reprocessing project. There were several people on the Medica end and they were not sure how to answer that so the presenter had me send her an email and she will be following up on it. Until I hear back from them I wont be sending corrected claims.

 

 

 

 

We are not putting the HIPPS code- just the G codes and the # of 15 minute units-  does it require the HIPPS code-  We got paid 1 unit because we did not have the 15 minutes units on the claim- I have to do adjustments on all my claims.

 

 

 

 

 

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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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