April,

 

Just an FYI – it usually takes a good 30 days for them to pay once I fax that Adjustment/Appeal request, but they do pay.

 

I just got 3 more of these denials yesterday. 

 

Marnie

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Hanson,April
Sent: Thursday, June 16, 2022 11:39 AM
To: billers@list.mnhomecare.org
Subject: Re: [EXTERNAL] Medica Denials

 

**External Sender**

 

Did you see Marnie's email? I found this helpful. I think this may be a good place to start might save some time calling on all of them. See below. Good luck!

 

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.

 

Description: PL color home care

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> on behalf of Sara Sundberg <sara@gnhomecare.com>
Sent: Thursday, June 16, 2022 11:08 AM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: Re: [EXTERNAL] Medica Denials

 

I don't remember this being a regular issue with Medica. I have never sent medical records and have authorizations for all of my HHA visits. There is absolutely no reason for this chaos. So, frustrating that it is simply a way for them to delay paying. I absolutely hate calling, but it looks like I will have to do that. 

 

Sara

 

On Wed, Jun 15, 2022 at 9:12 AM Vig,Terisa <TVig@riverviewhealth.org> wrote:

I am having the same problem.  What our medical records department said from their denial training is that is a tactic payers are using to not pay claims.  Stupid thing is that they end up adding interest when they do pay.  I have to call on all of the claims and TELL them to reprocess.  It is their problem and I shouldn't have to do an appeal.  Happens every year.  Usually it is June claims that deny.  They started a month early this year.  

 

Terisa Vig
Patient Account Representative
RiverView Health Home Care
tvig@riverviewhealth.org

218-281-9240

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> on behalf of Sara Sundberg <sara@gnhomecare.com>
Sent: Tuesday, June 14, 2022 6:14 PM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] Medica Denials

 

Hello,

 

Is anyone else having issues with Medica, MSHO specifically? Starting with dates of service in May, I am getting about half of my claims denied. The code is M127: Missing patient medical record for this service. Most of them are SNV, but a few HHAV. I have verified eligibility and ID numbers. 

 

--

Sara Sundberg

CFO

Good Neighbor Home Health Care

218-829-9238

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--

Sara Sundberg

CFO

Good Neighbor Home Health Care

218-829-9238

www.gnhomecare.com

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