Hello Sara,

 

Yes, when on a Dual plan, if the patient meets Medicare criteria you will bill differently. 

 

For the Dual plans (Medicare portion), our agency bills PDGM.  For some reason with the UCare Dual plan, when we bill under the Medicare portion, we bill per month and not per 30 days. But the rest of the claim looks like PDGM.

 

I hope this helps.

 

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 Sara Sundberg
Sent: Friday, July 22, 2022 3:26 PM
To: billers@list.mnhomecare.org
Subject: DUAL Question

 

**External Sender**

 

Okay, I am going to ask what I feel is a dumb question, but I am sitting here doubting myself and my prior knowledge. You all are extremely knowledgeable and helpful. 

 

If someone is on a DUAL plan, I will use UCare DUALS-MSHO as an example, do I need to bill "Medicare" services differently than if I was just billing MA services? Do I have to do an NOA and bill it episodically? I have mostly just maintenance clients, so they are the MA side of the dual plan and I bill them by the visit. 

 

Any guidance would be greatly appreciated. I still feel really dumb about this. Maybe I just need more coffee. 

 

--

Sara Sundberg

CFO

Good Neighbor Home Health Care

218-829-9238



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