If you want to correct the claims, you can. You won’t be in timely filing as they have been processed and paid. The right thing to do would be to correct them. However, the payer paid them as their system processed them. You could call the payer and ask them. Also, how much of a difference would it be for what you were paid versus what you would have been paid for visit. If they did not pay an outlier, you are probably ok.

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Hanson,April
Sent: Tuesday, March 28, 2023 12:54 PM
To: billers@list.mnhomecare.org
Subject: optum bundled and nonbundled

 

Good afternoon, We had a patient that had an authorization updated and should have had a payer change from Optum bundled to nonbundled. Somehow the payer change was missed. The claims billed as bundled and paid as bundled. I am assuming we

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Good afternoon,

We had a patient that had an authorization updated and should have had a payer change from Optum bundled to nonbundled. Somehow the payer change was missed. The claims billed as bundled and paid as bundled. I am assuming we need to go and rebill the claims as nonbundled since the payment is usually lower for nonbundled claims than bundled, but I wanted to check with this group first. My concern is the authorization was updated about a year ago. Will we run into issues with timely filing? Has anyone had a similar situation? How did you handle it. Thank you!

 

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.

 

 

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