We bill for waivered services regularly. Case Managers need to submit a WSAF form (see attached). The attached example is specific to the COLA split but can be used for anything. You must wait for the WSAF to be approved. Ucare will
fax you a copy of the service agreement that you can bill against. This isn’t billed through MNITs it’s billed directly to Ucare. We manually bill for our services via clearinghouse called Health EC (E-connect).
Ucare is having trouble processing claims with the COLA increase and improperly overpaying claims from July forward. The Case Manager does not need to submit a revised WSAF for this (see attached) but you do need to make Ucare aware of
this issue. I’ve reached out to their clinical services area. If you receive overpayments you should send those claims to
clsintake@ucare.org so Ucare can reprocess these claims properly. Most of their departments struggle with understanding waivered services and how we are different from everything else so your answers will vary depending
on who you speak to when you call with questions.
Hope this helps!
Cindy
Cindy Erkel
Accounting Coordinator
MRCI
1961 Premier Drive, Suite 318 | Mankato, MN 56001
D: 507-386-5708 | T: 800-829-7110 | F: 888-800-7336
Mankato | Chaska | Fairmont | New Ulm
| Rosemount | Shakopee
As an industry leader, MRCI is excited to offer two online options.
Participant Dashboard is an online viewing portal to review monthly spending and E-Timesheets is a one stop online timesheet submission.
Connect with me to learn more. MRCI, your selected FMS provider.
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Tina Tomberlin
Sent: Thursday, October 17, 2019 2:22 PM
To: 'billers@list.mnhomecare.org' <billers@list.mnhomecare.org>
Subject: RE: [External] RE: MSHO Patients who are also on a waiver
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There is a DHS form that County Case managers are supposed to submit to U-Care (really all Medicaid plans but only UCare forces it) I think it’s like 5148 or 4158 (??)
They will absolutely will not give authorization until they receive this form from the County Case Manager. I have fought with several case managers to get this form sent to UCare, but you are stuck until they
receive this form.
From:
billers@list.mnhomecare.org [mailto:billers@list.mnhomecare.org]
On Behalf Of Tuma, Darlene
Sent: Thursday, October 17, 2019 2:13 PM
To: billers@list.mnhomecare.org
Subject: [External] RE: MSHO Patients who are also on a waiver
****ALERT - External Email Sender****
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are you billing under Medicare for those services? That would change things
From:
billers@list.mnhomecare.org [mailto:billers@list.mnhomecare.org]
On Behalf Of Jennifer Larsen
Sent: Thursday, October 17, 2019 1:51 PM
To: billers@list.mnhomecare.org
Subject: RE: MSHO Patients who are also on a waiver
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.
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
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Tuma, Darlene
Sent: Thursday, October 17, 2019 1:47 PM
To: billers@list.mnhomecare.org
Subject: RE: MSHO Patients who are also on a waiver
are you doing homemaking or some other service?
From:
billers@list.mnhomecare.org [mailto:billers@list.mnhomecare.org]
On Behalf Of Jennifer Larsen
Sent: Thursday, October 17, 2019 1:46 PM
To: billers@list.mnhomecare.org
Subject: RE: MSHO Patients who are also on a waiver
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.
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
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Tuma, Darlene
Sent: Thursday, October 17, 2019 1:38 PM
To: billers@list.mnhomecare.org
Subject: RE: MSHO Patients who are also on a waiver
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
From:
billers@list.mnhomecare.org [mailto:billers@list.mnhomecare.org]
On Behalf Of Jennifer Larsen
Sent: Thursday, October 17, 2019 1:05 PM
To: billers@list.mnhomecare.org
Subject: MSHO Patients who are also on a waiver
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
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