What she meant is depending on how providers are contrcted with United Health, you bill episodes or per visit but with the hipps code on line 1. So this will stay the same but for providers who are contracted
to bill epsidoes, thye will bill PDGM. For providers who are contracted to bill per visits, they will bill per visit in 2020 but with new PDGM hpps codes.
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Kori Meyer
Sent: Thursday, January 02, 2020 9:59 AM
To: billers@list.mnhomecare.org
Subject: RE: pdgm
I take the last sentence to mean that contracted providers are to bill PDGM HIPPS codes after 1/1/20, but that they are still doing 60d episodes since they are not changing their reimbursement
methodology. I think. Please explain if you see it another way! Kind of clear as mud.
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Jennifer Larsen
Sent: Thursday, January 2, 2020 9:53 AM
To: billers@list.mnhomecare.org
Subject: RE: pdgm
Sorry, I should have stated this in my 1st email. I suppose it will be PPS until our current contracts re-new or if they are working on amending them and will implement the changes one by one for providers.
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 Kori Meyer
Sent: Thursday, January 2, 2020 9:25 AM
To: billers@list.mnhomecare.org
Subject: RE: pdgm
Just got this today. Highlighting and underlining are Aaron’s.
|
||||||
Hi Kori,
Please see the information below regarding UHC and PPS or PDGM as of January 1, 2020.
UnitedHealthcare will recognize the upcoming 1/1/2020 CMS modification to the Home Health Prospective Payment System (HH PPS) from “HHRG” (Home Health Resource
Groups) to “PDGM” (Patient-Driven Groupings Model) for non-participating Home Health care providers.
However, for participating providers contracted under the standard M&R Home Health payment appendix with negotiated, fixed rates, those payment appendices will not automatically
implement the new PDGM reimbursement methodology.
Home Health providers, whether or not they are contracted under the Home Health PPS methodology, are required to submit claims with Revenue Code 0023 and
applicable HIPPS (Health Insurance Prospective Payment System) codes. As the Home Health payment appendix only requires “applicable HIPPS codes” and doesn’t specify “HHRGs”, the appropriate HIPPS code as of 1/1/2020 will be those specific to PDGM.
Thank you,
Aaron
Aaron Thomson
UnitedHealth Networks
Provider Relations Advocate
MN, ND, & SD
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Salin, Tracy M
Sent: Monday, December 23, 2019 8:31 AM
To: billers@list.mnhomecare.org
Subject: RE: pdgm
They have not confirmed. I believe they will.
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Patti Fladwood
Sent: Monday, December 23, 2019 8:28 AM
To: billers@list.mnhomecare.org
Subject: pdgm
Does anyone know if United Healthcare is going to PDGM??
Patti Fladwood
BILLING SUPERVISOR
Optage Homecare, Hospice, and Primary Care
Presbyterian Homes & Services
2845 Hamline Avenue North, Roseville, MN 55113
Tel:(651)631-6198; Email:
pfladwood@preshomes.org
Optage®
is the home and community services division of Presbyterian Homes & Services.
"This electronic mail transmission may contain confidential health information that is protected by law. It is not intended for transmission to, or receipt by, any
unauthorized persons. If you have received this electronic mail transmission in error, please shred it, and notify the sender by reply electronic mail transmission so that our records can be corrected."
This electronic mail transmission (including any attachments) may contain confidential health or other information that is protected by law. It is not intended for transmission
to, or receipt by, any unauthorized persons. If you have received this electronic mail transmission in error, please delete it, and notify the sender by reply electronic mail transmission so that our records can be corrected.
CONFIDENTIALITY NOTICE: This message (including any attachments) may contain confidential client information. The information is intended only for the use of the individual or entity
to whom it is addressed. If you're not the addressee or the employee or agent responsible to deliver this e-mail to its intended recipient, you are hereby notified that any review, use, dissemination, distribution, disclosure, copying or taking of any action
in reliance on the contents of this information is strictly prohibited. If you have received this communication in error, please notify the sender immediately, delete this message from your computer and ask your network administrator to delete it from any
storage or back up files.