Oh, also, you will get a denial fi you bill Triwest without the auth number so what I do is generate my claims and send them when I have the auth #. VA in Minneapolis
has a huge issue with processing authorizations through and they know this. WE need to keep on top of them to ensure they continue to make improving this process a priority. I was told not to bill my claims until they have the authorization processed. I do
not. Here’s why. They have to pay interest for past due processed claims. My job as a biller is to bill in a quick and timely manner. That is precisely what I do and it is beyond me when they do not process authorizations in a timely manner resulting in them
not getting claims processed on time. I don’t think they are very happy about this as I was told I shouldn’t do this. I also was told they are frustrated because we have a hold on admission for VA covered clients. We are doing this because their inability
to catch up on their extremely slow processing of authorizations resulting in extremely late paying of claims has become a huge hindrance to our daily work with VA covered clients. I spend an extremely large amount of time trying to get my VA authorization
letters and get my VA claims paid. Hopefully Triwest will be help things improve however unless VA gets the processing through of authorizations, I do not see this happening. I do know they are trying to work on this.
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Kelly Rader
Sent: Wednesday, May 22, 2019 1:56 PM
To: 'billers@list.mnhomecare.org' <billers@list.mnhomecare.org>
Subject: RE: Minneapolis VA
One more question. Do the dates on the auth for the 60 days you got from VA have to exactly match with the episode dates you are billing?
Thanks for all your help with this!
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: Tuesday, May 14, 2019 3:14 PM
To: billers@list.mnhomecare.org
Subject: RE: Minneapolis VA
I think the reason why is because if you don’t have an auth number, they may not have received info from the VA. My BIGGEST problem is VA auths my services but
they don’t process it all the way through. So you probably could bill it without because they had the auth on file.
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Muench, Stacie J
Sent: Tuesday, May 14, 2019 1:27 PM
To: billers@list.mnhomecare.org
Subject: Re: Minneapolis VA
I hadn't been entering the auth number in the memo field for the RAP claims and they did pay. But I'm thinking after reviewing all these emails I should probably start entering the auth numbers
just to be safe.
Stacie Muench
Billing Representative
Essentia Health Home Care West- Ada, Detroit Lakes, Fargo
Essentia Health Home Care Graceville
114 Frazee Street East
Detroit Lakes, MN 56501
Ph: 218-314-7834
Fax# 218-847-0850
Stacie.Muench@EssentiaHealth.org
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From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org> on behalf of Kelly Rader <Kelly.Rader@HennHomeCare.com>
Sent: Tuesday, May 14, 2019 12:42:19 PM
To: billers@list.mnhomecare.org
Subject: RE: Minneapolis VA
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.
Great! Just checking to see if you put their auth # in the memo area at the bottom of the claim.
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 Muench, Stacie J
Sent: Tuesday, May 14, 2019 12:40 PM
To: billers@list.mnhomecare.org
Subject: Re: Minneapolis VA
So far we have gotten paid for 20 RAP claims. It's a good start but am expecting way more RAP payments.
Stacie Muench
Billing Representative
Essentia Health Home Care West- Ada, Detroit Lakes, Fargo
Essentia Health Home Care Graceville
114 Frazee Street East
Detroit Lakes, MN 56501
Ph: 218-314-7834
Fax# 218-847-0850
Stacie.Muench@EssentiaHealth.org
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.
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org> on behalf of Kelly Rader <Kelly.Rader@HennHomeCare.com>
Sent: Tuesday, May 14, 2019 12:36:05 PM
To: billers@list.mnhomecare.org
Subject: RE: Minneapolis VA
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.
Marnie. Have you had any luck with the episodic billing to Triwest for your VA clients? Just checking if anyone has been getting paid for the RAPs and Finals.
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: Friday, March 15, 2019 11:20 AM
To: billers@list.mnhomecare.org
Subject: RE: Minneapolis VA
My explanation from them yesterday was only nurse visits and therapies. HHA is to continue to be billed to VA. They could not say how payment would be. However, with Healthnet, our three claims to them paid
well.
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Rettig, Lynette
Sent: Friday, March 15, 2019 11:00 AM
To: 'billers@list.mnhomecare.org' <billers@list.mnhomecare.org>
Subject: RE: Minneapolis VA
Is Triwest for the VA really going to pay like a “Medicare” episode Rap and Final- won’t all disciplines including HHA will have to be included or is this for nursing visits only?
What about Homemaker services??
Lynette Rettig
Billing Supervisor
Ridgeview Home Health Services
501 S. Maple St STE 1
Waconia MN 55387
952-442-6030 Ext 35520
From:
billers@list.mnhomecare.org [mailto:billers@list.mnhomecare.org]
On Behalf Of Salin, Tracy
Sent: Friday, March 15, 2019 10:49 AM
To: billers@list.mnhomecare.org
Subject: RE: Minneapolis VA
*CAUTION - EXTERNAL EMAIL* This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe.
Oh boy. I am cringing on the inside. Yes many of our VA clients are 4 or less visits per month. They can’t tell us how payment will be made. I wonder if we could find someone who currently works with them and
see how they get paid. See how things work.
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Jennifer Larsen
Sent: Friday, March 15, 2019 10:05 AM
To: billers@list.mnhomecare.org
Subject: RE: Minneapolis VA
Hello all, I am a day late on this but wanted to provide some information we were told. Most of our VA patients are not considered homebound (which I know does not apply for TriWest) but with them not being homebound their SN need is
very minimal, so in a 60 day episode they may only receive a max of 4 SN visits, which is going to cause them to LUPA with TriWest.
I found a form on Availity where you can request to become a network provider with TriWest, you just fill it out and they are supposed to get in touch with you. I did that a month ago, along with requesting access to their web portal
and I haven’t heard back or received anything from them.
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Jessica Anderson
Sent: Thursday, March 14, 2019 10:40 AM
To: billers@list.mnhomecare.org
Subject: RE: Minneapolis VA
We received one authorization so far and yes it is confusing. I am also working with the VA because in order to bill episodically our recertification dates and our authorizations dates need to match and they do not currently due to the
VA making some authorizations longer than 60 days. I am very grateful that I have a great lady at the St Cloud VA that I am working with to get the dates to match!
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Marnie Pogreba
Sent: Thursday, March 14, 2019 10:25 AM
To: 'billers@list.mnhomecare.org' <billers@list.mnhomecare.org>
Subject: RE: Minneapolis VA
We started getting authorizations from Tri West a month ago. They are confusing. At the bottom of the authorization it has procedure codes: G0151 – G0153 and G0299 – G0300, which as you know are Therapy and
SN codes. The authorization also says Quantity is 1 Unit. 1 unit means the duration of the 60 day episode, the 60 day episode = 1 unit. In other words, the authorization is good for SN visits and Therapy visits during that 60 day episode. Tri West requires
a RAP and Final claim in 60 day episodes just like Medicare. Since we get a code from the OASIS for the authorization number on Medicare type claims, I asked them where we are to put the authorization number that we get from Tri West. The person I spoke
to told me to put that in the Remarks. We have not been paid yet for the RAPs that I have sent, so I cannot say for sure how this is working out.
I agree – this reminds me of health net all over again.
Here is an attachment that might be helpful:
http://www.triwest.com/en/vapc3-provider/FAQs/Billing-Frequently-Asked-Questions.pdf
Marnie
Lakewood Health System Home Health
From:
billers@list.mnhomecare.org [mailto:billers@list.mnhomecare.org]
On Behalf Of Jessica Anderson
Sent: Thursday, March 14, 2019 10:05 AM
To: billers@list.mnhomecare.org
Subject: RE: Minneapolis VA
LAKEWOOD HEALTH SYSTEM SECURITY NOTICE:
This email originated from an external sender. Ensure you know the sender before clicking on any links or attachments.
No, Triwest will be the payer source as well so you will not get paid if you do not switch to Triwest.
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Rettig, Lynette
Sent: Thursday, March 14, 2019 9:56 AM
To: 'billers@list.mnhomecare.org' <billers@list.mnhomecare.org>
Subject: RE: Minneapolis VA
Can we refuse to transition to TRIWEST?
Lynette Rettig
Billing Supervisor
Ridgeview Home Health Services
501 S. Maple St STE 1
Waconia MN 55387
952-442-6030 Ext 35520
From:
billers@list.mnhomecare.org [mailto:billers@list.mnhomecare.org]
On Behalf Of Jessica Anderson
Sent: Thursday, March 14, 2019 9:55 AM
To: billers@list.mnhomecare.org
Subject: RE: Minneapolis VA
*CAUTION - EXTERNAL EMAIL* This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe.
Tracy,
We work mostly with the St Cloud VA but what we were told is that Triwest will only be managing skilled nursing at this time, VA will still manage and authorize aide and homemaker visits. Nurse visits will transition to Triwest as authorizations
renew. We are still waiting to get set up correctly with Triwest, the info they had for us is incorrect, we’ve been working on this for over a month. It has not been a great experience
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Salin, Tracy
Sent: Thursday, March 14, 2019 9:46 AM
To: billers@list.mnhomecare.org
Subject: Minneapolis VA
We work with the Minneapolis VA mostly. WE had a provider agreement with them during the Healthnet contract where we worked directly with the VA. Now that Healthnet contract is over, Triwest has taken over managing the veterans Choice
program. So they are sending us authorizations that are very confusing. They also said we are supposed to bill Triwest. I am not sure where we stand as we had a provider agreement with the VA and I have no clue who to talk to. Does anyone else have this happening
to them? I don’t even know who to contact at the Minneapolis VA.
Tracy Salin
Billing Specialist
Fairview Range Home Care and Hospice
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