This is what I heard from the nurse coordinator I work with at VA.
We have been told that they do not need an Oasis for non-bundled.
How does one get a HIPPS code without OASIS?
Darlene Tuma, RN, PHN
Adult Health Supervisor
Le Sueur County Public Health
88 South Park Ave
Le Center, MN 56057
507-357-8249
Fax: 507-357-4223
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From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Jessica Demarais
Sent: Thursday, May 21, 2020 12:19 PM
To: billers@list.mnhomecare.org
Subject: RE: VA
That’s the way we read it, but it’s very unclear, so we are waiting for further guidance. It would be very helpful to get a Rep to do a webinar or something that provides us with a more clear path, so right now we are just trying to make
sense of it the best we can!
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Tuma, Darlene
Sent: Thursday, May 21, 2020 11:55 AM
To: billers@list.mnhomecare.org
Subject: RE: VA
You are saying unbundled still needs OASIS? I didn’t get that from my contact so will need to verify. We will be starting soon
Darlene Tuma, RN, PHN
Adult Health Supervisor
Le Sueur County Public Health
88 South Park Ave
Le Center, MN 56057
507-357-8249
Fax: 507-357-4223
Confidentiality Notice
This e-mail contains confidential information which is legally privileged. The information is intended for use by the intended recipient only. If you are not the
intended recipient, you are hereby notified that any disclosure, copying, distribution, or taking of any action regarding this information except its direct delivery to the intended recipient is strictly prohibited. If you received this e-mail in error, please
notify us immediately by return reply and then delete this e-mail
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Jessica Demarais
Sent: Thursday, May 21, 2020 11:50 AM
To: billers@list.mnhomecare.org
Subject: RE: VA
We are all set up with the network, but have not yet had success getting claims through, and they keep getting rejected. We currently have a ticket open to get this resolved, but it’s been about a month unresolved. We are billing FFS,
but with Hipps code, as they required. For non bundled services, they have advised to bill this way, and for bundled services to be billed episodic. Not entirely sure how that will work unless the payor gets set up both ways, but as of now, we have all non
bundled services.
It’s still a work in progress over here!
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Kelly Rader
Sent: Thursday, May 21, 2020 11:41 AM
To: billers@list.mnhomecare.org
Subject: RE: VA
Has anyone been registered, billed and been paid by OPTUM for SNV? If so, are you billing fee for service or episodic?
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Marnie Pogreba
Sent: Tuesday, May 5, 2020 11:55 AM
To: 'billers@list.mnhomecare.org' <billers@list.mnhomecare.org>
Subject: RE: VA
We have been struggling with getting Optum to register our home care. Until then, the VA has been sending us authorizations to continue to bill the VA as we have been. The VA was denying my claims that were
not dropping with TOB 323. As long as I make sure my TOB is 323 they have been paying them. I have also noticed for us, our claims are processing quicker than they were in the past.
We put the authorization number in box 63.
Marnie
From:
billers@list.mnhomecare.org [mailto:billers@list.mnhomecare.org]
On Behalf Of Julie Embry
Sent: Tuesday, May 05, 2020 11:30 AM
To: billers@list.mnhomecare.org
Subject: RE: VA
|
**External Sender**
|
Jess – did you see the one agency bills VA with a 34x vs 32x..? I think we were reading to submit type 333…
Julie Embry
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Jessica Demarais
Sent: Tuesday, May 5, 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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