Did you just accept payment or have any luck with appeal?

 

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Alicia Schmidt
Sent: Tuesday, September 29, 2020 3:38 PM
To: billers@list.mnhomecare.org
Subject: RE: Friendly Reminder ...

 

Yes, we have had a similar situations.  We don’t show it should be a LUPA under PDGM guidelines, but they are paying per visit.  Almost as if they didn’t update that portion in their software at BCBS.

 

Alicia Schmidt

Accounts Receivable Lead

2715 Hwy 29 S Ste 103, Alexandria, MN, 56308

Office: 320-759-3340 | Fax: 320-759-1275

knutenelson.org | Nonprofit Senior Lifestyle Provider

 

 

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This message is intended for the sole use of the individual and entity to whom it is addressed, and may contain information that is privileged, confidential and exempt from disclosure under applicable law.  If you are not the intended addressee, nor authorized to receive for the intended addressee, you are hereby notified that you may not use, copy, disclose or distribute to anyone the message or any information contained in the message.  If you have received this message in error, please immediately advise the sender by reply email and delete the message. Thank you.

 

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

www.mnhomecare.org | kpeterson@mnhomecare.org

 

 

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Vision: MHCA will shape the home care landscape to improve and sustain quality home care services.

 

 

 

 

 

 

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This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error please notify the system manager. This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system. If you are not the intended recipient you are notified that disclosing, copying, distributing or taking any action in reliance on the contents of this information is strictly prohibited.