To expand on Marnie, ALL medicaid and Medicaid replacement plans are billed per visit not bundled billing. You would not show hipps code or bill NOA. We have our dual plan payers set up two ways in our system so we can just change payer
when it goes from the medicare side to the Medicaid side or vice versa.
I am currently having an incredibly difficult time getting my blue plus msho claims to process to pay. I was just in meeting between Fairview and Blue Cross. They are still reviewing this issue. They seemed to think it came about from
a system update done 9/15/21 however I clarified my claims have been denying since February of 2021. So if anyone else is continuing to have this issue, reach out on here please.
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Marnie Pogreba
Sent: Thursday, March 17, 2022 10:23 AM
To: billers@list.mnhomecare.org
Subject: RE: Blue Plus Dual coverage
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Here is how I bill:
Blue Plus MSHO (Medicaid portion) No NOA
Blue Plus MSHO (Medicare portion) Yes, bill NOA.
Marnie
Lakewood Health System Home Care & Hospice
Phone: 218 894 8324
Email:
marniepogreba@lakewoodhealthsystem.com
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Jenifer Baker
Sent: Thursday, March 17, 2022 10:13 AM
To: billers@list.mnhomecare.org
Subject: Blue Plus Dual coverage
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**External Sender**
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I'm wondering if any of your clients that have Blue Plus with MN MSHO Dual and elderly waiver eligible folks get billed as a no pay RAP? Or do you bill yours through Blue Plus managed care?
I always get a little confused when a person is Medicare eligible, but has a managed care plan and is also on Medicaid? ... goodness.
Thanks!
--
Jenifer Baker, OTR, PTA, COS-C
Agency Director
Firstat Nursing Services
Comprehensive Home Care and Therapy Services
2395 Ariel St. N,
Suite A
Maplewood, MN 55109
Office: 651-288-0222 ext. 2003
Direct Number: 651-409-4378
Fax: 651-288-0214
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