Hello everyone,

I have still been doing a bunch of research and trying to find information online about this whole Ucare MSHO/Connect Plus disaster. I actually finally found in writing what the 2023 Ucare provider manual states about billing for these plans. See below:

Home Care Services Criteria:

*****UCARE’S MINNESOTA SENIOR HEALTH OPTIONS (MSHO) AND UCARE CONNECT + MEDICARE UCare’s MSHO and UCare Connect + Medicare combine Medicare and Medicaid benefits; therefore, UCare follows both Medicare and Medicaid criteria for coverage. Medicare standards are reviewed first. If a request for home care does not meet Medicare criteria, it is reviewed using Medicaid criteria. For Medicaid criteria for home care services, refer to the Medical Necessity Criteria section of this manual.

Too me Ucare is denying these claims in error. It states if the clients don’t meet Medicare criteria that then the benefits move to their Medicaid plan and we would bill with Medicare’s billing requirements? Why would we bill with a 34X type of bull and occ code of 50 when those are MC billing requirements. When have you ever added an Occ code 50 on a claim that we are billing “T”-codes and not G-codes. I know I have not.

I believe this is a Ucare error.

Traci Olson

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

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