April, did you submit an auth request to VA or TriWest? If the auth is sent to VA – we typically get an approval within a couple days so that we know if services continue or not…hard auths from TriWest tend to take a long time but you get
the soft approval in writing from VA if it is sent in on time…
Annetta Smith
LPN, Billing Specialist
(O)651-388-2223
(F)651-388-2227
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From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Hanson,April
Sent: Monday, March 2, 2020 8:49 AM
To: billers@list.mnhomecare.org
Subject: RE: Triwest auth
Thank you for your responses. Triwest did not authorize ongoing auth. We had auth through Triwest through 12/26/19. I have two further questions:
-
What is your company’s policy regarding authorization. If an insurance company is not authorizing ongoing do you hold services? Ethically this is something our facility really struggles with. And it seems like we all have different opinions on how this should
be handled.
-
On admit do you provide services that do not have authorization? We have to admit within 48 hours, but what if the authorization is still pending with the insurance company?
Thank you!
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Kelly Rader
Sent: Monday, March 2, 2020 8:12 AM
To: billers@list.mnhomecare.org
Subject: [EXTERNAL] RE: Triwest auth
Are you saying VA would not authorize or that Triwest does not have auth in their system? If VA would not auth then you should not bill anything after 12.26.2019.
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Salin, Tracy M
Sent: Monday, March 2, 2020 8:07 AM
To: billers@list.mnhomecare.org
Subject: RE: Triwest auth
If they did not authorize, we would not have provided the service. They should have authorized it. I think you are out of luck.
Tracy Salin
Billing Specialist
Fairview Range Home Care and Hospice
Phone: 218-262-6982
Fax: 218-262-1723
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Hanson,April
Sent: Saturday, February 29, 2020 12:16 PM
To: billers@list.mnhomecare.org
Cc: Doll,Jennifer <Jennifer.Doll@PerhamHealth.org>; Schaefer,Katlin <Katlin.Schaefer@PerhamHealth.org>
Subject: Triwest auth
Good morning,
We have a patient that authorization through Triwest ended 12/26/19 and from 12/27/2019-1/13/2020 they would not authorize. Our rap is dated 12/30/19 and falls within the no auth range. They denied it for auth. I am assuming our final claim
is going to deny for not having a rap processed. Have any of you run into this issue? Do you end up writing off the entire episode? Triwest and VA have both been terrible about processing our auth requests the date that they complete it, not the date they
receive it. Just wanted some additional input or suggestions if anyone has any. Thank you!
April Hanson
Patient Accounts
Perham Living
Ph: 218.347.1894
F: 218.347.1885
Dedicated to health and wellness throughout life.
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