I submitted LUPA claims and they returned them stating I needed to submit a RAP. I also submitted RAPS and then finals and they returned the finals stating I needed to submit a RAP. I did receive payment on one RAP, other than that i haven't seen any payments. Very frustrating, and now we go back to VA for all the billing because they didn't truly understand how Episodic billing and skilled nursing worked. They are in a class all their own and they don't know who the teacher is.

On Tue, Aug 27, 2019 at 9:16 AM Marnie Pogreba <marniepogreba@lakewoodhealthsystem.com> wrote:

Hello,

I am wondering if anyone else is having the issue that I am having with our subsequent Tri West episodes? Because the subsequent 60 day episode start date does not match the first visit date, Tri West has been denying our RAP claims.

Is anyone else having this issue and would you know of a work around? Right now I call Tri West and try to explain the Medicare billing rules on subsequent claims (hoping they get it) and ask for the RAP to be sent back for reprocessing.

Thank you,
Marnie

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