Shhhh just enjoy your success. Lol…. So jealous!!! I have 5 different denial codes

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Sara Sundberg
Sent: Tuesday, March 28, 2023 3:47 PM
To: billers@list.mnhomecare.org
Subject: Re: UCare

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I have had all my UCare claims paid. I bill on a UB-04 with TOB 32X. I use T and S codes. I do not have the 50 Occurrence code on my claim. I honestly did not change anything from 2022 to 2023. Other than a few new people needing authorizations, once UCare got caught up and started processing claims, I have had no issues. I wish I knew why and could offer assistance, but maybe this one time I am lucky.

Sara

On Tue, Mar 28, 2023 at 3:43 PM Hanson,April <April.Hanson@perhamhealth.org> wrote:

That's exactly what I thought! Nothing would surprise me. I will say though I think the 34X type of bill would make more sense than adding the 50-occurrence code with assessment date with this type of plan. When I had called on the claims that I had sent in with the 50-occurrence code on them for SNBC and MSHO MA plans, they had told me we need the Q codes on the claims which didn't make any sense. I will update you all on how these claims process. 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 Marnie Pogreba <marniepogreba@lakewoodhealthsystem.com>
Sent: Tuesday, March 28, 2023 3:38 PM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] RE: UCare

April,

Yes, the UCare SNBC and UCare MSHO (Medicaid) plans seem to be the trouble. Please let us know how that billing works out for you. It seems like what works for some to get their claims processed is not necessarily working for others. This is the first I have heard of using TOB 34X for UCare. But with UCare nothing surprises me.

Thank you,

Marnie

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Hanson,April
Sent: Tuesday, March 28, 2023 3:32 PM
To: billers@list.mnhomecare.org
Subject: Re: UCare

**External Sender**

Good afternoon everyone,

I have been digging into the ucare claims more. Is everyone having the Ucare SNBC and Ucare MSHO (patients on Medicaid side of payer) claims deny? Is anyone having them pay? Our IT department reached out to another home care agency that has not been having any issues with getting their claims for these plans paid and they are billing with T and S codes with 34X type of bill and no 50-occurrence code. I am going to try this route on a few claims to see if this is what they are looking for. Just thought I would bring it to this group to see if anyone is having luck billing this way. Hoping this is the solution. The claims that I tried to resubmit with a 50-occurrence code and assessment date denied again. Let me know your thoughts. 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 Marnie Pogreba <marniepogreba@lakewoodhealthsystem.com>
Sent: Friday, March 17, 2023 9:57 AM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] RE: UCare

With that many claims, I would call UCare, see if they have this issue resolved and ask them to reprocess your claims. That’s what another agency did that reached out to me.

Marnie

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Allison Delwiche
Sent: Friday, March 17, 2023 9:53 AM
To: billers@list.mnhomecare.org
Subject: RE: UCare

**External Sender**

Good Morning,

Did anyone find out of we have to use the assessment date with the 50 occurrence code? We have 200+ claims to resend so I don’t want to look them all up if I don’t have to 😊

Thanks,

Allison Delwiche

Regency Home HealthCare
651-488-4655 Office
651-488-4656 Fax

Confidentiality Notice: The information contained in this message may be privileged and confidential and protected from disclosure. If the reader of this message is not the intended recipient, or an employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please notify us immediately by replying to the message and deleting it from your computer. Thank you.

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Hanson,April
Sent: Wednesday, March 15, 2023 4:34 PM
To: billers@list.mnhomecare.org
Subject: Re: UCare

I have the same question as Terisa! And does the assessment date have to fall within the dates of the claim? I have a ticket open with Epic but haven't heard back from them yet. I would like to get it to pull that correct assessment date on it's own so I don't have to try to figure out which one to use.

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 VIG,TERISA <TVig@riverviewhealth.org>
Sent: Wednesday, March 15, 2023 3:16 PM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] Re: UCare

I don't understand why the PMAP MA people are getting denied as of January 1st. Reading all these messages it doesn't seem like anyone else does either. There should be no difference in how we bill UCARE for a non-medicare episode than how we bill DHS. No other payer requires all these work arounds (and are they really work arounds or is Ucare going to figure it out and take all the money back?)

What am I missing? Besides over $10,000 in payments because Ucare doesn't pay no matter what I do? I am tired of changing claims and resubmitting and then having them tell me, no you need to bill it like PGDM and it's not a Medicare episode.

How are you getting the date to put in for Occurrence code 50? EPIC doesn't do it automatically so I am manually looking them up.

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 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

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!

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Sara Sundberg

CFO

Good Neighbor Home Health Care

218-829-9238