I did a chat with Optum two weeks ago, it is an ongoing problem with my claims. I was told it is a known system issue and they hoped to have a fix in 30 days, at that time they will do a query to identify all claims and reprocess the claims
that are denying in error. I did a print screen of my whole chat because I never trust what they tell me.
Marnie
Lakewood Health System Home Care & Hospice
218 894 8324
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Kaitlin Johnson
Sent: Wednesday, November 10, 2021 12:39 PM
To: billers@list.mnhomecare.org
Subject: Re: Optum
|
**External Sender** |
Just wanting to follow up on this since it seems like so many of us were having the same issue.
Was anyone able to get their claims processed correctly? I haven't and when I call optum they don't seem to understand.
On Fri, Oct 22, 2021 at 10:47 AM Kelly Rader <Kelly.Rader@hennhomecare.com> wrote:
I just entered a FFS claim in to XPRESS Claim in OPTUM VACCN and the reimbursement rate is showing on the claim. Hopefully they fixed the issue.
Kelly Rader
Billing Specialist
Hennepin Home Health Care
763-425-5959 ex 44
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Kelly Rader
Sent: Friday, October 22, 2021 9:53 AM
To: billers@list.mnhomecare.org
Subject: RE: Optum
We have issues with payments, also. Sometimes they pay us per the VA FEE schedule (per unit) and sometimes they pay our billed customary rate. Never know what to expect.
Kelly Rader
Billing Specialist
Hennepin Home Health Care
763-425-5959 ex 44
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Mary Hanson
Sent: Friday, October 22, 2021 8:44 AM
To: billers@list.mnhomecare.org
Subject: RE: Optum
We too just recently started being paid our full rate charge after paying us discounted rate. I am holding my breath they don’t reprocess and take back the money!
Mary Hanson | Billing Specialist | River Valley Home Care Inc.
916 8th Street Farmington, MN 55024
Phone: 651-460-4201
Email: mhanson@rvhci.com
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Vig,Terisa
Sent: Thursday, October 21, 2021 1:29 PM
To: billers@list.mnhomecare.org
Subject: Re: Optum
Our non bundled claims started getting paid at our full charge rate.
They had been paying a discounted rate which is what I was told by them our contract stated. After arguing and supplying the contract that clearly states we will be paid at full rate for a year, they are now paying it the way the contract says. It started on our 10/15 remit.
I wonder if they will go back and pay us the missing$? Hah hah.
Get Outlook for iOS
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> on behalf of Kelly Rader <Kelly.Rader@hennhomecare.com>
Sent: Thursday, October 21, 2021 1:13:54 PM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] RE: Optum
I just started seeing an issue. Our auths are for non-bundled and we were not having any issues getting paid. As of processing date around 10.14.2021 all are claims are marked as PAID but the reimbursement rate is $0.00 for all services. I have chatted with several representatives during the last few days and have been getting a lot of different answers. One person told me that the rates are not loaded in to their system. I actually called yesterday and got someone who could see what I was talking about. She moved this issue to a lead.
Kelly Rader
Billing Specialist
Hennepin Home Health Care
763-425-5959 ex 44
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Marnie Pogreba
Sent: Thursday, October 21, 2021 12:21 PM
To: billers@list.mnhomecare.org
Subject: RE: Optum
Hello,
Recently, Optum has been denying my non-bundled claims entirely. I have reached out to them using the live chat option on the Optum website. I noticed it all depends on who you get, some of the people do not understand the billing rules and have tried to tell me that my type of bill is wrong. Yesterday, I just had to tell the person I was chatting with, that I had to go and would try back later. Then I tried again and got someone who understood and was sending my claims back to be processed correctly.
I don’t understand why all of a sudden there are issues, things were going pretty good.
Marnie
Lakewood Health System Home Care & Hospice
218 894 8324
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Kaitlin Johnson
Sent: Thursday, October 21, 2021 12:15 PM
To: billers@list.mnhomecare.org
Subject: Optum
**External Sender**
Hello Everyone!
Optum VA is suddenly paying my non-bundled claims as bundled episodes, I have call 2 people at Optum and they are both telling me that it's paid correctly but this doesn't seem right to me.
There are no HIPPS codes on the claims and claims are sent as non-bundled. Authorizations are also non-bundled.
Wondering if this has happened with any of your claims?
--
Kaitlin Johnson, RN
Lake Region Home Health
(320) 354-5858
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Kaitlin Johnson, RN
Lake Region Home Health
(320) 354-5858