That is frustrating and the provider services are not much help. If you are sending your BCBS Medicare Advantage claims to BCBS MN, they should be processing the RAP and the Final.
L
Marnie
Lakewood Health System
From: billers@list.mnhomecare.org [mailto:billers@list.mnhomecare.org]
On Behalf Of Brittany Schwecke
Sent: Monday, August 05, 2019 2:32 PM
To: billers@list.mnhomecare.org
Subject: RE: BCBS Medicare Advantage Claims
LAKEWOOD HEALTH SYSTEM SECURITY NOTICE:
This email originated from an external sender. Ensure you know the sender before clicking on any links or attachments.
Yes the services were authorized. No pmt on either RAP. I had one of them reprocessed already and still came back not paying. When I asked about the
initial and FINAL claim, she said yes just submit the final claim and you ‘should’ receive pmt.
Brittany Schwecke
Accountant
Renville County Public Health Services
105 South 5th 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 Marnie Pogreba
Sent: Monday, August 5, 2019 2:18 PM
To: 'billers@list.mnhomecare.org' <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.
Brittany,
I have had some issues with them paying the RAP and then taking it back and not paying the Final claim, I have had to call on those claims to have them reprocessed. And, I have had some that have processed correctly,
the RAP and Final.
Have you been getting an authorization for the visits you are billing?
Marnie
Lakewood Health System
From:
billers@list.mnhomecare.org [mailto:billers@list.mnhomecare.org]
On Behalf Of Brittany Schwecke
Sent: Monday, August 05, 2019 9:57 AM
To: billers@list.mnhomecare.org
Subject: RE: BCBS Medicare Advantage Claims
LAKEWOOD HEALTH SYSTEM SECURITY NOTICE:
This email originated from an external sender. Ensure you know the sender before clicking on any links or attachments.
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 5th 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.
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 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!
Brittany Schwecke
Accountant
Renville County Public Health Services
105 South 5th Street, Suite #119H
Olivia, MN 56277
Direct: 320-523-3721
Public Health : 320-523-2570
Email :
brittanys@renvillecountymn.com
Web :
www.renvillecountymn.com
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