IT makes sense to have it match the service agreement which should be the agency rates as this is what the client sees. They don’t understand reimbursement rates. They do understand the EOB they get from insurance which shows what we charged and what they paid, contractual and patient responsibility. The whole point is so clients see what is being billed, why it isn’t covered by Medicare and then what they could end up owing if there is no coverage. The general person off the street thinks Medicare pays for health care period. They don’t know the limitations. It’s up to us to explain to them by using service agreements and ABNS.

 

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 Tammy Kluver
Sent: Tuesday, February 02, 2021 7:10 AM
To: billers@list.mnhomecare.org
Subject: RE: ABNs

 

That is what some of our staff interprets it ,  and the others think it should be the Medicare rate.. I just want to do it correct.  Interesting on everyone’s take on it.  On survey’s we have never been asked about it.

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Brand, Vickie K
Sent: Monday, February 01, 2021 3:18 PM
To: billers@list.mnhomecare.org
Subject: RE: ABNs

 

CAUTION: This email originated from outside your organization. Exercise caution when opening attachments or clicking links, especially from unknown senders.

Box F on the ABN should be an estimate of what the patient will need to pay for the service(s) listed in Box D.

 

According to the form instructions (below), we need to inform the patient of their financial responsibility so the patient can make an informed decision. My interpretation is that we need to inform the patient of the rates they will be charged if there are no other payers (i.e.- our private pay rates).

 

 

6. Blank (F) Estimated Cost: Notifiers must complete the column under Blank (F) to ensure the beneficiary has all available information to make an informed decision about whether or not to obtain potentially non-covered services.

Notifiers must make a good faith effort to insert a reasonable estimate for all of the items or services listed under Blank (D). In general, we would expect that the estimate should be within $100 or 25% of the actual costs, whichever is greater.

 

 

Vickie Brand, BSN, RN, PHN

Compliance Coordinator

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Vickie.brand@allina.com

Allina Health Home Health

Mail Route 34100 • 1055 Westgate Drive Suite 100 • St. Paul, MN 55114-1451 

 

Hours: Mon, Wed, Thurs  6:00 am-2:30 pm

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Salin, Tracy M
Sent: Monday, February 1, 2021 2:55 PM
To: billers@list.mnhomecare.org
Subject: [External Mail] RE: ABNs

 

CAUTION: This email originated from outside of the Allina Health network. Do not click links or open attachments unless you recognize the sender and know the content is safe.

You put the rate you put on your claims, not the reimbursement rate from medicare. Each payer has different rates. So agencies have a set prices for services because you can’t charge more for a nurse visit to one payer than another. It is usually more than what insurances pay so we do a contractual adjustment. The ABN rat should be what YOUR service agreement rate is. This reduces confusion for the client.

 

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 Tuma, Darlene
Sent: Monday, February 01, 2021 2:53 PM
To: billers@list.mnhomecare.org
Subject: RE: ABNs

 

That what we have been doing. Can the MHCA nurse consultants shed some light on this?

 

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 Hespe, Linda J
Sent: Monday, February 1, 2021 2:49 PM
To: billers@list.mnhomecare.org
Subject: RE: ABNs

 

I would say on an ABN, it would be the skilled or Medicare rate because that is what you are saying they aren’t eligible for based on the homebound status, wouldn’t it?

 

Linda Hespe RN, MBA

Director

Essentia Health Home Care and Hospice West

114 Frazee Street East   Detroit Lakes, MN 56501

P: 218-314-7806 F: 218-847-0850

Linda.Hespe@EssentiaHealth.org  www.essentiahealth.org

 

 

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Tammy Kluver
Sent: Friday, January 29, 2021 11:23 AM
To: billers@list.mnhomecare.org
Subject: RE: ABNs

 

WARNING: This email originated outside of Essentia Health. DO NOT CLICK links or attachments unless you recognize the sender and know the content is safe.

 


Agree homemaking will not go on there.  But you say “our rates”  is that your private pay rates then?  We have Private pay rates and Medicare rates

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Salin, Tracy M
Sent: Friday, January 29, 2021 11:20 AM
To: billers@list.mnhomecare.org
Subject: RE: ABNs

 

CAUTION: This email originated from outside your organization. Exercise caution when opening attachments or clicking links, especially from unknown senders.

If it’s not a medicare covered service, then no it does not belong on abn. We use our rates and we put the service type and the general care for the services types on the abn.

 

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 Tammy Kluver
Sent: Friday, January 29, 2021 11:09 AM
To: Billers@list.mnhomecare.org
Subject: ABNs

 

A question on ABN’s….

 

When filing in Box F  do you use your private pay rate or Medicare rate as a general rule?

 

In Box D  you put in Skilled Nurse, Home health aide…do you ever put in Homemaker or no because it is never covered by Medicare?

 

Thanks

 

Tammy Kluver

Homecare & Hospice

 

 

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