😊 Yes!

Melissa Austreng

Home Care and Housing Biller

Assumption Community 715 1st Street North Cold Spring, MN 56320

Phone: 320.348.2358

Email: austreng.melissa@assumptionhome.com

Web: www.assumptioncommunity.com

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Marnie Pogreba
Sent: Thursday, August 29, 2019 2:38 PM
To: 'billers@list.mnhomecare.org' <billers@list.mnhomecare.org>
Subject: RE: Tri West subsequent episodes

LOL – yes!

From: billers@list.mnhomecare.org [mailto:billers@list.mnhomecare.org] On Behalf Of Salin, Tracy
Sent: Thursday, August 29, 2019 2:37 PM
To: billers@list.mnhomecare.org
Subject: RE: Tri West subsequent episodes

LAKEWOOD HEALTH SYSTEM SECURITY NOTICE:
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Anyone else feel this way?

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Hanson,April
Sent: Thursday, August 29, 2019 2:30 PM
To: billers@list.mnhomecare.org
Subject: RE: Tri West subsequent episodes

I had the exact same thing happen! I also just got off the phone resending a bunch of claims that initially denied for CBSA code missing that I had submitted 327 TOB on with original claim number in the document control number spot and the CBSA code corrected. They all had denied for billing error. The rep and her supervisor said that should not have happened so she is sending them all back for reprocessing. Most of the others that I sent back this way processed and paid no problem. I am not sure why the claims are processing differently?

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Salin, Tracy
Sent: Thursday, August 29, 2019 2:26 PM
To: billers@list.mnhomecare.org
Subject: [EXTERNAL] RE: Tri West subsequent episodes

OMG!!!!! Lol, two value codes in one box…. How does that work???? We should have a billers convention! Who else could understand our struggles???

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Marnie Pogreba
Sent: Thursday, August 29, 2019 2:23 PM
To: 'billers@list.mnhomecare.org' <billers@list.mnhomecare.org>
Subject: RE: Tri West subsequent episodes

Thank you Tracy.  I will hang on to this information.  I called TriWest today, first I was told that the claims are denying because my Value Codes 61 and 85 both needed to be in box 39, not with VC 61 in box 39 and VC 85 in box 40.  That sounded crazy to me, the person I spoke to put me on hold to check with her supervisor to verify that.  So then I had them look at a past claim that paid just fine.  I was told to fax a list of all 13 of my claims that are denying to the representatives supervisor, Sylvia.  If I do not have any success with that, I will try reaching out to Renee.

From: billers@list.mnhomecare.org [mailto:billers@list.mnhomecare.org] On Behalf Of Salin, Tracy
Sent: Thursday, August 29, 2019 1:47 PM
To: billers@list.mnhomecare.org
Subject: RE: Tri West subsequent episodes

LAKEWOOD HEALTH SYSTEM SECURITY NOTICE:
This email originated from an external sender.  Ensure you know the sender before clicking on any links or attachments.

Marnie, I just spoke with a Renee at Triwest. It seems they have one or two claims processors who didn’t understand how to process ongoing episodes. She corrected the issue and is going to have any incorrectly denied RAPs reprocessed for me. Her e-mail is rwolfe@triwest.com . If you e-mail her a list of claims denied for this reason, she will probably be able to help.

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Marnie Pogreba
Sent: Tuesday, August 27, 2019 9:17 AM
To: 'billers@list.mnhomecare.org' <billers@list.mnhomecare.org>
Subject: Tri West subsequent episodes

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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