I don't know how your software works but with EPIC it is a pain but I do go with the new auth IF it includes all the disciplines because having two auths with the same services and the same dates does not work in EPIC.  You have to end one before it will allow another to start.  If it is just adding new auth for Therapies, our software recognizes that and puts the charges on different claims with the corresponding authorization/referral number.

And yes, I have problems with Optum paying if there are two auths open for the same services and overlapping dates.  I call them and have them end the one before the new one starts.  I keep a spreadsheet with auth start/end dates because they get off chronologically with the cert periods no matter how hard I try to align them every time I send in a RFS. I specifically put the date I want the new one to start and 9/10 times they ignore it and start it whenever they want.  I haven't figured out a rhyme or reason for it yet.  

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 Hanson,April <April.Hanson@PerhamHealth.org>
Sent: Thursday, August 25, 2022 9:06 AM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Cc: Helmbrecht,Jessica <Jessica.Helmbrecht@PerhamHealth.org>
Subject: [EXTERNAL] Optum Bundled
 
Good morning,
I have a patient that is currently on a bundled Optum payer. Their current auth runs through 9/6/22 (also when their episode ends) and includes SN. They are wanting to add some therapies. VA is wanting to authorize it on a new auth starting before this patients new episode would start. I am concerned that having two overlapping authorizations may cause trouble. Has anyone had this situation? Did your claim pay okay? I am thinking back to the days of Triwest billing and some of the claims with overlapping authorizations that still have not paid. Any suggestions you may have to avoid a billing mess later would be greatly appreciated. Thanks!

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


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