FYI above (older bulletin) if helpful/needed.

Thank you – Kevin

Kevin D. Sevick, MBA

Billing Supervisor - Home Health/Hospice and Senior Care Billing
Essentia Health

Revenue Services | BSC
4614 Mike Colalillo Drive, Duluth, MN 55807

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Hanson,April
Sent: Monday, April 3, 2023 9:47 AM
To: billers@list.mnhomecare.org
Subject: Re: blue plus MSHO PDGM

WARNING: This email originated outside of Essentia Health. DO NOT CLICK links or attachments unless you recognize the sender and know the content is safe.

I also am having this issue. I believe I have only had 2 or 3 deny for this. I also called and had them sent back for review stating the require NOA's I also gave them the NOA claim numbers. I am not sure what the outcome is yet.

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: Monday, April 3, 2023 9:14 AM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] RE: blue plus MSHO PDGM

Yes, I had 2 Blue Plus MSHO claims deny for a RAP. I called provider services, even gave them the NOA claim numbers and asked for the claims to be sent back for reprocessing. I received a letter back from BCBS/Blue Plus saying they were upholding their denial. I reached out to our facility’s BCBS Representative, I gave her my claim numbers and the BCBS Bulletin that says they are now requesting NOA’s and not RAP’s. She was escalating this at Amerigroup. Hopefully they will get things straightened out sooner than later.

Marnie

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Mortenson,Crisa
Sent: Monday, April 03, 2023 9:03 AM
To: 'billers@list.mnhomecare.org' <billers@list.mnhomecare.org>
Subject: blue plus MSHO PDGM

**External Sender**

Is anyone having trouble with BCBS MSHO billing being denied for RAP? I've had to call and get some sent back for review and reprocessing and while some have paid, one came back and denied stating they do need a RAP now? So, did something change with their processing that anyone knows? I thought they just required NOAs since last July.

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

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