I am just wondering if anyone else is seeing that they are changing the Auth’s for nursing to bundled? We have been seeing this a lot lately and these clients are chronic and was wondering what I should do to get this changed?

Shay Cates

Office Clerk

320-286-2158 ext 100

From: billers@list.mnhomecare.org [mailto:billers@list.mnhomecare.org] On Behalf Of Kaitlin Johnson
Sent: Thursday, November 11, 2021 8:05 AM
To: billers@list.mnhomecare.org
Subject: Re: Optum

Yes, that is the error I'm getting!

On Wed, Nov 10, 2021 at 3:27 PM Hanson,April <April.Hanson@perhamhealth.org> wrote:

I have had some claims deny with that issue too.

April Hanson

Patient Accounts

Perham Living

Ph: 218.347.1894

F: 218.347.1885

April.Hanson@perhamhealth.org

Dedicated to health and wellness throughout life.

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> on behalf of Marnie Pogreba <marniepogreba@lakewoodhealthsystem.com>
Sent: Wednesday, November 10, 2021 3:25 PM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] RE: Optum

Sounds very much like the reason we are getting.

Marnie

Lakewood Health System Home Care & Hospice

218 894 8324

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Hanson,April
Sent: Wednesday, November 10, 2021 3:22 PM
To: billers@list.mnhomecare.org
Subject: Re: Optum

**External Sender**

Is this the error you guys are all getting on the claims? I've just started receiving some denials for this reason.

April Hanson

Patient Accounts

Perham Living

Ph: 218.347.1894

F: 218.347.1885

April.Hanson@perhamhealth.org

Dedicated to health and wellness throughout life.

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> on behalf of Marnie Pogreba <marniepogreba@lakewoodhealthsystem.com>
Sent: Wednesday, November 10, 2021 1:29 PM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] RE: Optum

Thank you Kaitlin. 😊

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Kaitlin Johnson
Sent: Wednesday, November 10, 2021 1:21 PM
To: billers@list.mnhomecare.org
Subject: Re: Optum

**External Sender**

I just chatted with Optum again a few minutes ago. They told me about the system error. They are telling me to fax a spreadsheet of all claims that I need reprocessing when their system updates. Fax 833-376-3047

They did tell me this 3-4 weeks ago and I did fax them, but my claims were reprocessed the exact same, hopefully it works in the near future!

On Wed, Nov 10, 2021 at 1:11 PM Kelly Rader <Kelly.Rader@hennhomecare.com> wrote:

Marnie, Ours are not denying. They are showing paid but at a $0.00 rate. I believe you are having the same issue. I, also, chatted with Optum and was told the same thing after many conversations.

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: Wednesday, November 10, 2021 1:00 PM
To: billers@list.mnhomecare.org
Subject: RE: Optum

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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recipient, please contact the sender by reply e-mail and destroy
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--

Kaitlin Johnson, RN

Lake Region Home Health

(320) 354-5858

--

Kaitlin Johnson, RN

Lake Region Home Health

(320) 354-5858

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Confidentiality Notice: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
privileged and confidential information. Any unauthorized review, use,
disclosure or distribution is prohibited. If you are not the intended
recipient, please contact the sender by reply e-mail and destroy
all copies of the original message.

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Confidentiality Notice: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s) and may contain
privileged and confidential information. Any unauthorized review, use,
disclosure or distribution is prohibited. If you are not the intended
recipient, please contact the sender by reply e-mail and destroy
all copies of the original message.

Kaitlin Johnson, RN

Lake Region Home Health

(320) 354-5858