are you billing under Medicare for those services? That would change things

 

 

My bad, I just realized she is on a Ucare Connect, which does require auth from Ucare but they are saying waiver. And we are offering SN, PT, MSW, HHA AND OT. So no HMKR, we only provide homemaker to our VA people.

 

 

 

are you doing homemaking or some other service?

 

 

Thanks Darlene, we were aware of no auth for RN and HHA but they are trying to say since she is also on an elderly waiver that we need auth from the county for her home care services.

 

 

 

Is someone is on CADI, the county case manager needs to submit the auth request for services. UCARE MSHO (people over age 65) does not require authorizations for RN/Aide this year. May change for next year.

Darlene

 

 

Hi all, I have not worked with waivers much since all services we offer are covered  by Medicare, a health plan offering an Advantage, MSHO, PPO type plans and Medicaid. We have recently run into hiccups with some of our patients specifically on a UCare MSHO and that also are on a waiver, CADI and Elderly. We do not need to bill in MN-its for any of the services but yet UCare is denying claims stating auth is required through the County Worker, but that auth would be for the waiver services we would bill through MN-its, in which we do not need. And the County workers don’t call us back anyways. Has anyone run into this and if so how were you able to finally get it clear to UCare that this doesn’t need to be authed through the County?

 

Also, is there any online training type sessions that you know of that offer Waiver training?

 

Thank you in advance for any advice.

 

Jen

 

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

www.gaehomecarehospice.org

 

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