https://ndocsoftware.com/2019/03/understanding-pdgm-what-you-need-to-know-what-you-need-to-do/
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 Karen Gorecki
Sent: Tuesday, September 29, 2020 2:28 PM
To: billers@list.mnhomecare.org
Subject: RE: Friendly Reminder ...
Has anyone had any experience with BCBS PDGM payment regarding less than 4 visits?
Had a 30 day episode that had 2 visits. In billing software it says LUPA is 2 visits. According to billing software support if LUPA says 2 and we do 2 then should be paid full episode.
We have been paid what appears to be LUPA rate for the 2 visits provided.
Did on line dispute and payment was upheld.
Any suggestions/similar experience?
Thanks
Karen
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Karen Peterson
Sent: Friday, September 25, 2020 3:08 PM
To: billers@list.mnhomecare.org
Subject: Friendly Reminder ...
Hey all,
Thank for your swift responses with info on your interaction with Humana.
Please remember that we are not to share specific contract details (such as rates) when discussing payers; this could lead to issues with antitrust rules which we of course all want to avoid!
Thanks for your understanding,
Karen Peterson
Regulatory Affairs and Advocacy Manager
Minnesota HomeCare Association
2550 University Ave. W., Ste. 350 S | St. Paul, MN 55114-1900
Direct: 651.659.1457 | Main: 651.635.0607
Toll-free: 866.607.0607 | Fax: 651.635.0043
Mission:
MHCA represents and supports Minnesota home care providers committed to high quality home care services.
Vision:
MHCA will shape the home care landscape to improve and sustain quality home care services.
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