This specific plan is billing code option C. (same for both my cases I was dealing with).

I was unsure if anyone has experience with BCBS paying the RAP or just everything on the FINAL?

Brittany Schwecke

Accountant

Renville County Public Health Services

105 South 5^th Street, Suite #119H

Olivia, MN 56277

Direct: 320-523-3721

Public Health : 320-523-2570

Email : brittanys@renvillecountymn.com

Web : www.renvillecountymn.com

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Annetta Smith
Sent: Monday, August 5, 2019 9:55 AM
To: billers@list.mnhomecare.org
Subject: RE: BCBS Medicare Advantage Claims

RENVILLE COUNTY SECURITY NOTICE:

WARNING: This message originated from outside Renville County. Use caution when clicking hyperlinks or opening attachments.

Maybe check the plan bill code…

The Bill Option Code describes the beneficiary’s relationship with the MA plan. Valid codes are:

1 – Intermediary processes all (Part A and Part B) provider bill (unrestricted). Submit your claim to the intermediary.

2 – HMO processes directly provided services and arranged services. Intermediary processes all others (unrestricted).

A – Intermediary processes all (Part A and Part B) provider bills (restricted).

B – HMO to processes only bills for directly provided services (restricted); intermediary to process all other bills.

C – HMO to process all bills (restricted). Submit your claim to the Medicare Advantage plan.

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Annetta Smith, LPN

Billing Specialist

(M)1-651-442-0228

(O)1-651-388-2223

(F)1-651-388-2227

www.hiawathahomecare.com

hiawatha_homecare 40%

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Brittany Schwecke
Sent: Monday, August 5, 2019 9:16 AM
To: billers@list.mnhomecare.org
Subject: BCBS Medicare Advantage Claims

Does BCBS Medicare Advantage plans send payment for both RAP and FINAL or just FINAL claim? I have submitted 2 RAPs on different clients and both are not being paid. Wondering if this is because something is wrong with the claim or because they only send payment on FINAL claim?

Tried talking to BCBS about this, but of course the customer service reps don’t understand Advantage plans. Any insight would be great, Thanks!