This whole process is a joke. The exact same problem continues as it always has been with the VA. They approve and auth services but dot process the auths so that claims can pay. From what I have gathered, and
I have done EXTENSIVE research, the issue is STILL when the authorized services do not get assigned an internal number and sent over to Triwest the same as they were never finished through so Fee Basis could process claims. I am BEGGING my boss to stop working
with the VA until this is fixed once and for all. The Minneapolis VA is broken. Carla Posch is a head of something there and I am supposed to be able to e-mail her a list of auths I am missing. I have e-mailed her several times and only get 1-2 auths finished
through then nothing. It is completely a waste of resources for homecare providers to work with the VA at this point. We should NOT have to fax for auth, then provide services only to not be able to bill because our claims will deny because they can’t figure
out how to timely process authorizations. We should NOT have to keep management at the VA on their toes. They ARE aware of the issue. I have had several people at the VA agree with me as to what the problem is. This is causing SEVERE disruptions to our work
here and a growing backlog of AR because I can’t bill Triwest for multiple claims as they will only deny until the auth is processed. I am almost through my 2nd cert periods for veterans and still don’t have auths processed so I can bill the first.
I also am highly concerned about the move to Optum as we have had trouble working with them in the past. Time to write to lawmakers and get them to STOP making changes to the VA.
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Tuma, Darlene
Sent: Tuesday, July 16, 2019 9:54 AM
To: billers@list.mnhomecare.org
Subject: RE: MPLS VA / TriWest
We have not processed any with Triwest yet. I questioned the OASIS and how to proceed. I just received an email from Sheri, the nurse coordinator supervisor and she told me this:
We can put veterans through Triwest anytime. Once you do the OASIS, let the RN working with you know the start of care date. We can stop the one auth and start another with Triwest. We can only use VA funds until 9/30 for skilled care so
the earlier you complete the OASIS, the better.
Thank you,
Sheri Lechner, MSN, MBA, HCM
ANM Community Care
Minneapolis VAHCS
1 Veterans Drive
Minneapolis, MN 55417
612-725-8042
I don’t think this Triwest is going smoothly plus, I was told that next October it will again switch to Optum. Lots of differents scenarios floating around isn’t there.
Darlene
From:
billers@list.mnhomecare.org [mailto:billers@list.mnhomecare.org]
On Behalf Of Jennifer Larsen
Sent: Tuesday, July 16, 2019 9:38 AM
To: billers@list.mnhomecare.org
Subject: RE: MPLS VA / TriWest
A couple weeks ago my Director was told by someone at the MPLS VA that they had pulled back all their auth requests from Triwest because they were editing them. She wasn’t provided anymore details than that. Yesterday I received some SN
auths for a St. Cloud Vet, but the auth is now coming from St. Cloud VA for SN, called them and was told that some providers had complained about the reimbursement from Triwest and that they are now NOT sending the auths to Triwest and it is all being handled
through the VA again. Has anyone else heard this?
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Annetta Smith
Sent: Tuesday, July 16, 2019 9:20 AM
To: billers@list.mnhomecare.org
Subject: RE: MPLS VA / TriWest
We have not seen one yet, our auths are being approved at the VA level but nothing has come from TriWest with an auth number for billing.
Annetta Smith, LPN
Billing Specialist
(M)1-651-442-0228
(O)1-651-388-2223
(F)1-651-388-2227
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Jennifer Larsen
Sent: Tuesday, July 16, 2019 9:17 AM
To: billers@list.mnhomecare.org
Subject: MPLS VA / Triwest
Morning all,
I am just wondering if any of you have received a Triwest auth for a MPLS Vet?
Thanks!
Be Compassionate. Be Accountable. Be Respectful. Be Excellent!
Jennifer Larsen
Claims Specialist
Guardian Angels Elim Home Care and Hospice
403 Main Street, Elk River, MN 55330
Main 763-241-0654
Direct 763-452-4101
Email
jlarsen@gaehc.org
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