Occurrence code 25 points to non coverage by primary payer. So if member has medicare primary and MA secondary but your service is not a medicare qualifying service, you don’t have to bill medicare for denial then MA. You bill MA but putt occurrence code 25 on claim. This should match date of your signed ABN form. This allows member’s secondary payer to process the claim for payment without denial from primary plan.

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of VIG,TERISA
Sent: Thursday, March 16, 2023 10:37 AM
To: billers@list.mnhomecare.org
Subject: Re: [EXTERNAL] Re: UCare

 

It used to be that my claims would be denied if I didn't have the 25 occurrence code & date. I don't see that your claim it and you were still getting paid? I called last week to Ucare and gave them all the people that denied and stated

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It used to be that my claims would be denied if I didn't have the 25 occurrence code & date.  I don't see that your claim it and you were still getting paid?

 

I called last week to Ucare and gave them all the people that denied and stated all the similarities/differences with payer types and group numbers to see if that was causing a problem.  Not a peep from them.  I called yesterday to see what the status of my case was and so far nothing has been determined.  

 

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 Mortenson,Crisa <Crisa.Mortenson@kmhc.net>
Sent: Thursday, March 16, 2023 9:50 AM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: Re: [EXTERNAL] Re: UCare

 

I didn't change my billing template either, but added the OCC code 50 once I got my first denial in January.  Funny thing is that only one person denied and the other two paid, but now I have the Occ code 50 on all claims.  Kind of seems no rhyme or reason as to why they are denying.  Have you sent a message in the ucare portal?  Here's what my February claim looks like for the person that denied in January - it's already been paid for my feburary billing

 

 

Crisa Mortenson

Billing Officer

 Phone: 218-843-3852

Fax : 218-843-2311

Email: crisa.mortenson@kmhc.net

 1010 S Birch Ave. P.O. Box 700

Hallock, MN 56728

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> on behalf of Sara Sundberg <sara@gnhomecare.com>
Sent: Thursday, March 16, 2023 9:47 AM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] Re: UCare

 

Terisa, 

 

I did not change anything that I was doing from 2022 to 2023 for my UCare MSHO clients and I have gotten all my claims paid. I do not have the OC 50 on them. I am billing FFS with T codes. I have no clue why mine are working and others are struggling. I am struggling with UCare Medicare. The whole thing is frustrating. 

 

Sara

 

On Thu, Mar 16, 2023 at 8:11 AM Melanie Ramse <MelanieRamse@accentcare.com> wrote:

Thank you, Crisa! 

 

Mel

 

Melanie Ramse | Lead A/R Specialist 

Office:   651-232-2810 ex 37262

Email:    MelanieRamse@accentcare.com

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Mortenson,Crisa
Sent: Thursday, March 16, 2023 8:04 AM
To: billers@list.mnhomecare.org
Subject: Re: UCare

 

Mel - I have received all payments for my ucare claims from February already and no denials. Hopefully that continues! I did not add a Q code though? Crisa Mortenson Billing Officer Phone: 218-843-3852 Fax : 218-843-2311 Email: crisa. mortenson@ kmhc. net

Mel - I have received all payments for my ucare claims from February already and no denials.  Hopefully that continues!  I did not add a Q code though?  

 

 

Crisa Mortenson

Billing Officer

 Phone: 218-843-3852

Fax : 218-843-2311

Email: crisa.mortenson@kmhc.net

 1010 S Birch Ave. P.O. Box 700

Hallock, MN 56728

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> on behalf of Melanie Ramse <MelanieRamse@AccentCare.com>
Sent: Wednesday, March 15, 2023 2:48 PM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] RE: UCare

 

Hi Crisa,

 

We have been billing FFS -not PDGM and getting paid for January 2023 claims with OCC Code 50 and adding Q code.  I am now seeing denials for February 2023 claims with the remarks, Not paid separately when the patient is an inpatient.   Are you experiencing any denials on your claims?

 

Thank you,

Mel R.

 

Melanie Ramse | Lead A/R Specialist 

Office:   651-232-2810 ex 37262

Email:    MelanieRamse@accentcare.com

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Mortenson,Crisa
Sent: Wednesday, March 15, 2023 10:33 AM
To: billers@list.mnhomecare.org
Subject: Re: UCare

 

I've been submitting mine FFS - not PDGM and getting paid on it once adding the OCC code 50. Crisa Mortenson Billing Officer Phone: 218-843-3852 Fax : 218-843-2311 Email: crisa. mortenson@ kmhc. net 1010 S Birch Ave. P. O. Box 700 Hallock, MN 56728

I've been submitting mine FFS - not PDGM and getting paid on it once adding the OCC code 50.

 

 

 

Crisa Mortenson

Billing Officer

 Phone: 218-843-3852

Fax : 218-843-2311

Email: crisa.mortenson@kmhc.net

 1010 S Birch Ave. P.O. Box 700

Hallock, MN 56728

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> on behalf of Staci Boehmer <sboehmer@lifespark.com>
Sent: Wednesday, March 15, 2023 10:20 AM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] RE: UCare

 

We are submitting the NOA’s and 30 day episodes, which includes the occ code 50

 

 

 

Staci Boehmer

Home Health and Hospice Billing Manager

Direct: 952-428-7295

Email: sboehmer@lifespark.com | www.lifespark.com

 

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From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Sent: Wednesday, March 15, 2023 10:16 AM
To: Billers@list.mnhomecare.org
Subject: UCare

 

[External Email: Use caution when clicking on links or opening attachments.]

 

Hi everyone,

 

Circling back to our UCare troubles..

 

How are you billing the UCare Medicare plans? Are you submitting NOA's? Billing Episodically? Billing FFS and just adding the occurrence code on the claim? 

 

Thank you!

 



"We Improve People's Lives"

Megan Klapperich

Billing Supervisor
Interim HealthCare of the Twin Cities
2680 Arthur St | Roseville MN 55113
651-259-4218  | Mobile: 612-271-8747 | Fax: 651-259-4248

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