OK so yes, Elizabeth is right. Cindy Hawkenson advised me to watch my authorization letters where it says on form 10-7080 look at services authorized on page 1. Bundled means bill episodic, unbundled means bill VA. Also look on page 2 of this form at the affiliation and network. If you don’t see Triwest or Optum, then you know you need to bill VA. If something doesn’t look right with the authorization, then call your contact at the VA.

Triwest number is 855-722-2838

VA claims number is 877-881-7618  (pick the non ccn network to get to va claims) you will be on a long wait so leave your number and they will call you back, and yes they do actually call back.  

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 Rettig, Lynette
Sent: Tuesday, May 05, 2020 10:48 AM
To: billers@list.mnhomecare.org
Subject: RE: VA

Our group has lots of claims with the VA, Triwest, etc that aren’t paid-  could you share some phone #’s that work to have VA and Triwest check on status of claims-  I get a lot of them that say no authorization too.

Are you putting the auth # in box 63 or the remarks box—I have tried both.

Since 2-19-20- Optum UHC has not accepted our enrollment- so we can’t bill through Optum UHC either.  Elizabeth Jenkins- my contact  at the VA tells me that I have to bill all the RN and PT since 2-19-20 the old way until Optum UHC will accept me as being in Network-  anyone else having that problem

Appreciate any help or phone numbers you can share

Thanks

Lynette Rettig

Billing Supervisor

Ridgeview Home Health Services

501 S. Maple St STE 1

Waconia MN 55387

952-442-6030 Ext 35520

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Salin, Tracy M
Sent: Tuesday, May 5, 2020 10:38 AM
To: billers@list.mnhomecare.org
Subject: RE: VA

 
*CAUTION - EXTERNAL EMAIL* This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. 
 

I am thinking the Triwest claims denying for no auth, with PDGM no treatment code is required anymore so our software put dummy zeroes in that spot. I did notice though they are phasing that out so I started putting them back into my claims. I think it worked because I just got a payment on a ton of my claims. However this is purely hypothetical. Gotta love the billing world.

Medical billing is like a puzzle that makes no sense sometimes.

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 Jessica Demarais
Sent: Tuesday, May 05, 2020 10:30 AM
To: billers@list.mnhomecare.org
Subject: RE: VA

We have the same struggles with VA claims.  I called them last week because many claims are denying for auth being absent,  but the auth number is right there on the claim, in the appropriate authorization box number.  We are also getting a lot of rejections for EDI reroute because somehow the claims are being routed to the wrong VA.  When I called VA, they explained that they have implemented a new auto claims processing system that could be causing all these rejections/denials.  I’m finding that I have to submit claims at least 3 times before they get processed.  It is very problematic, but there does not seem to be a good solution at this time.  Sometimes it takes 6 months to get claims paid.  It’s definitely concerning.

I wish I had better information, but I was basically asked to keep submitting the claims, and to continue to be patient with them. 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Summer Stahl
Sent: Tuesday, May 5, 2020 10:19 AM
To: billers@list.mnhomecare.org
Subject: VA

We are having issues with our billing department being able to process VA claims.  Any insight as far as billing (I understand we are supposed to follow MCR PDGM rules for TriWest and Optum) but claims are still rejecting.  I’m clinical so a little foreign to me, just trying to help our biller out.  Thank you, any cheat sheets would be appreciated!

Summer Stahl RN BSN

UHD Home Health & Hospice

507-526-7970 (office)

507-526-3285 (fax)

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