I got paid for a majority of my Ucare claims when I added the 50 occurrence code and date.  What I am seeing though is that UCARE SNBC and UCARE SNBC + MEDICARE are still NOT getting paid. Even with the 50 occurrence code and date added.  Maybe it is an issue with this specific plan. Just a thought. 

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Christine Strong
Sent: Thursday, March 9, 2023 7:40 AM
To: billers@list.mnhomecare.org
Subject: RE: *External Email Message*Re: UCare 1.1.23 claims

 

Good morning,

Sorry to bring this issue up again but we have added the occurrence code 50 with the assessment date to our Ucare claims and they are still denying.

 

When we called Ucare they read the denial reason Home Health Perspective system claims require a location of Q0001, Q002 etc.

Has anybody had to add the location to their claims?

 

Christine Strong

Accounts Receivable Manager

Adara Home Health

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Hanson,April
Sent: Thursday, March 2, 2023 10:24 AM
To: billers@list.mnhomecare.org
Subject: *External Email Message*Re: UCare 1.1.23 claims

 

Thank you all so much!

 

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 Kelly Rader <Kelly.Rader@hennhomecare.com>
Sent: Thursday, March 2, 2023 10:22 AM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] RE: UCare 1.1.23 claims

 

I added the 50 occurrence code and assessment date to all denied claims as of 1.1.2023 and resent them.   They were all paid yesterday.

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Hanson,April
Sent: Wednesday, March 1, 2023 1:32 PM
To: billers@list.mnhomecare.org
Subject: Re: UCare 1.1.23 claims

 

Tracy- I am wondering if you had any luck with your Ucare project? I have denials for Ucare January claims as well for not having occurrence code 50 on the claim. 

 

Is it just the occurrence code they are looking for or should these all be billed completely following CMS requirements? 

 

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.

 

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> on behalf of Salin, Tracy M - Tracy.Salin at fairview.org (via billers list) <billers@list.mnhomecare.org>
Sent: Wednesday, February 15, 2023 12:57 PM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] RE: UCare 1.1.23 claims

 

Its not an authorization issue. It’s a claims processing issue. My MA plans had 5 denials with M79 and 1 Medicare plan with M79. I called and explained to rep. She recommended I open a project as it affects more than 3 claims. I will be doing this. I of course am anticipating more denials as all my Jan claims haven’t processed yet… Funtimes!!!!! The occurrence code 50 points to oasis assessment/reassessment date for PDGM processing so insurance knows which one to look at for the HIPPS code so they can pay appropriately under pdgm rules. Ma plans are not PDGM.

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of VIG,TERISA
Sent: Wednesday, February 15, 2023 12:52 PM
To: billers@list.mnhomecare.org
Subject: Re: UCare 1.1.23 claims

 

I don’t know if this is just my issue but 5 clients switched to ucare Jan 1 and ucare did not set them up with Medicaid just Medicare connect so all of their claims denied with m79. I have our county workers looking into it for me. Those on

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I don’t know if this is just my issue but 5 clients switched to ucare Jan 1 and ucare did not set them up with Medicaid just Medicare connect so all of their claims denied with m79. I have our county workers looking into it for me. Those on ucare prior to Jan 1 paid fine. 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> on behalf of Mary Hanson <mhanson@rvhci.com>
Sent: Wednesday, February 15, 2023 12:38:25 PM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] UCare 1.1.23 claims

 

Hello All,

 

Finally received a remittance today with many January claims that had been unprocessed.  Some of these had shown in their system as pending with an amount of payment but unfortunately many claims denied.  Reason Code M79 – Missing/incomplete/invalid charge.

 

I did talk to provider services today.   Here is what I was told:

 

“Refer to the provider bulletin which reference CMS billing guidelines.  Missing Occurrence Code 50 with bill type 032X.”

 

My question to the group is what is everyone doing when they bill these claims with the plans they list in the bulletin which I have attached?  Are they wanting PPS billing?  Are you sending NOA’s?

 

One plan involved is UCare Connect + Medicare.  So, even though these are Medicaid claims they are processing them as Medicare?  I’m sorry but I am confused.

 

Any help on what you are doing that is working is greatly appreciated!!

 

Thank you.

 

Mary Hanson | Billing Specialist | River Valley Home Care Inc.

916 8th Street Farmington, MN 55024

Phone: 651-460-4201

Email: mhanson@rvhci.com

 

 

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