Thank you Mary. J

 

 

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I would assume that it will be across the board for all homecare agencies if you have been getting capped at charges rather than the PPS allowable.  My understanding is all claims that have been affected are to be reprocessed.

Hope this helps.

Mary

 

 

This might sound like a silly question.  By putting a fix in their system, do you know - would this be a fix that would affect all home care agencies and also, do you know if they plan on reprocessing claims from the last year, as Medicare would do if they put in a fix?

 

Thank you,

Marnie

 

 

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Finally had some success today- Ameri Group has agreed that our claims should not be capping out at charges and are putting a fix into their system!  ONLY TOOK CLOSE TO A FULL YEAR L

 

 

 

Yes, all year long! I was recently (Nov) told by their provider call center to bill the Final only, and to bill the amount we expected to be reimbursed according to Medicare’s PC Pricer. But I usually like to hear the same thing from at least more than one rep before I change my procedure, so we’re hoping we see or hear something from them that confirms this.

 

 

 

Is anyone else having issues with correct reimbursement from AmeriGroup on Medicare clients?  We have been underpaid for months due to them only paying charges on our finals and not paying RAPS at all.

 

 

 

Mary Jonason

Account Manager

Adara Home Health

Phone:763-682-0665 ext 1214

Fax:      763-682-6543

 

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