I don’t know if anyone else has gotten anywhere, but just wanted to give an update on our Ucare claims. I actually reached out to our provider relations contact, showed her examples of what is denying and cut and pasted what the bulletin said and also explained I thought Ucare was wrong in denying the claims bc the clients have MC and MA and the MA plan should be paying. After waiting and a few emails back and forth I found out that Ucare finally decided it was an error on their part. I was told the project will take 4-6 weeks to complete and claims will be reprocessed but who knows how long it will take.
Just thought I would share.
Traci Olson
Regency Home HealthCare
651-488-4655 Office
651-488-4656 Fax
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From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Sent: Thursday, April 13, 2023 1:41 PM
To: billers@list.mnhomecare.org
Subject: RE: Ucare billing issues disaster
Provider service at its finest
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Traci Olson
Sent: Thursday, April 13, 2023 1:22 PM
To: billers@list.mnhomecare.org
Subject: RE: Ucare billing issues disaster
OMG! I am 100% with you guys on this! Its like well thanks for the help. You can tell me its wrong but can’t tell me what to do to fix it! Traci Olson Regency Home HealthCare 651-488-4655 Office 651-488-4656 Fax Confidentiality Notice: The
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OMG! I am 100% with you guys on this! Its like well thanks for the help. You can tell me its wrong but can’t tell me what to do to fix it!
Traci Olson
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>
Sent: Thursday, April 13, 2023 12:46 PM
To: billers@list.mnhomecare.org
Subject: RE: Ucare billing issues disaster
That’s so true!!!!!!! Oh my gosh!!!!
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Hanson,April
Sent: Thursday, April 13, 2023 12:37 PM
To: billers@list.mnhomecare.org
Subject: Re: Ucare billing issues disaster
Right, I say the same. I also tell them that if they the insurance company don't know their own requirements how are us billers supposed to know. . . . April Hanson Patient Accounts Perham Living Ph: 218. 347. 1894 F: 218. 347. 1885 April. Hanson@ perhamhealth. org
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Right, I say the same. I also tell them that if they the insurance company don't know their own requirements how are us billers supposed to know....
April Hanson
Patient Accounts
Perham Living
Ph: 218.347.1894
F: 218.347.1885
Dedicated to health and wellness throughout life.
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org> on behalf of Salin, Tracy M - Tracy.Salin at fairview.org (via billers list) <billers@list.mnhomecare.org>
Sent: Thursday, April 13, 2023 12:33 PM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] RE: Ucare billing issues disaster
Yeah I usually respond with “ I AM the billing and coding department and I am telling you I need more info”. LOL………
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Hanson,April
Sent: Thursday, April 13, 2023 12:25 PM
To: billers@list.mnhomecare.org
Subject: Re: Ucare billing issues disaster
These insurances are about as clear as mud. I find it funny when I call insurances and they tell me "We can't advise you how to bill. You will need to contact your billing or coding department. " Well even if the billing dept has it
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These insurances are about as clear as mud. I find it funny when I call insurances and they tell me "We can't advise you how to bill. You will need to contact your billing or coding department." Well even if the billing dept has it right it doesn't mean the insurance is going to process the claim appropriately 🤣
April Hanson
Patient Accounts
Perham Living
Ph: 218.347.1894
F: 218.347.1885
Dedicated to health and wellness throughout life.
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org> on behalf of Traci Olson <Tolson@regencyhhc.com>
Sent: Thursday, April 13, 2023 12:19 PM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] RE: Ucare billing issues disaster
Right that is why I am saying Ucare has it all wrong. We actually are still billing all our institutional payers with 33x….Ucare MA has still been paying with that bill type. That may be a whole different issue. For this I don’t get why we need to bill like Medicare when Medicare doesn’t cover bc they don’t meet the criteria and the MA side of Ucare is paying.
I also have an email out to our provider relations person but have not heard back.
Thanks to those looking into this as well😊
Traci Olson
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: Thursday, April 13, 2023 12:10 PM
To: billers@list.mnhomecare.org
Subject: Re: Ucare billing issues disaster
It was on the SNBC and Ucare MSHO MA side of payer they were telling me to add Q codes on.
April Hanson
Patient Accounts
Perham Living
Ph: 218.347.1894
F: 218.347.1885
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: Thursday, April 13, 2023 12:08 PM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] RE: Ucare billing issues disaster
They have not been requiring the Q code when I bill my using the 32X and Cod 50 with the OASIS date. If you are billing the Medicare UCare plan, then, yes, it would require the Q code. That has been my experience.
Marnie
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Hanson,April
Sent: Thursday, April 13, 2023 12:05 PM
To: billers@list.mnhomecare.org
Subject: Re: Ucare billing issues disaster
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**External Sender** |
It's interesting though because when I tried rebilling leaving the 32X TOB and adding the 50 occurrence code they then told me it would require a Q code on the claim which didn't seem right.
April Hanson
Patient Accounts
Perham Living
Ph: 218.347.1894
F: 218.347.1885
Dedicated to health and wellness throughout life.
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org> on behalf of Hanson,April <April.Hanson@PerhamHealth.org>
Sent: Thursday, April 13, 2023 12:02 PM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] Re: Ucare billing issues disaster
I do have a message out to our contract person at Ucare about this issue. But I have not heard back. I sent a follow up message again this morning.
April Hanson
Patient Accounts
Perham Living
Ph: 218.347.1894
F: 218.347.1885
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: Thursday, April 13, 2023 11:54 AM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] RE: Ucare billing issues disaster
I do believe this is a UCare system error. To get my clams to pay, I have adding the occurrence code 50 with the OASIS date for that cert period. If UCare gets around to fixing this error, I do not think they would take my claims back, as having the code 50 with the OASIS date is actually just extra information.
UCare is very frustrating.
Marnie
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Traci Olson
Sent: Thursday, April 13, 2023 11:41 AM
To: billers@list.mnhomecare.org
Subject: RE: Ucare billing issues disaster
|
**External Sender** |
My other concern is if we do make the change that Ucare is saying (even though I believe they are wrong) what happens if they find out that it was actually an error on Ucare’s part and they never should have denied the first claims to begin with. Will they take back all those claims we fixed and rebilled.
Traci Olson
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: Thursday, April 13, 2023 10:36 AM
To: billers@list.mnhomecare.org
Subject: Re: Ucare billing issues disaster
When I rebilled the claims and received payment, I had billed with a 34X type of bill did NOT add 50 occurrence code on the claim. That is when they paid.
April Hanson
Patient Accounts
Perham Living
Ph: 218.347.1894
F: 218.347.1885
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: Thursday, April 13, 2023 10:33 AM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] Re: Ucare billing issues disaster
I totally agree. I am still trying to get access to the new portal because none of my Jan-Mar claims are in "old" portal. Very frustrating.
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 Traci Olson <Tolson@regencyhhc.com>
Sent: Thursday, April 13, 2023 10:24 AM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] Ucare billing issues disaster
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
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.
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