Good morning April,

Unfortunately, we always do a discharge and new start of care when the patient goes from a Bundled auth to a Non-Bundled auth, visa versa. We have to do this because Bundled claims bill out like Medicare and Non-Bundled claims do not. Our system will not set up for correct billing if we do not discharge and have a new SOC.

Marnie

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Hanson,April
Sent: Wednesday, April 26, 2023 8:40 AM
To: billers@list.mnhomecare.org
Subject: Optum bundled to nonbundled

**External Sender**

Good morning,

I am wondering if someone could answer a question for me. We have had some patients go from Bundled Optum to Nonbundled Optum. Does this require a full discharge and readmit? I was hoping we could do this without a discharge and readmit for the patient's that had their authorization change right after their episode ended since the change did not take place in the middle of their claim. IT is wondering Does Optum require a new SOC for the FFS payer. In other words-without doing a discharge and readmit, there will be no discharge for the PDGM payer and the admission date on the nonbundled claims will still show the original admit date and not an admission date equal to the first day the new payer was effective. Is this okay or do we need to go through the whole Discharge and readmit 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.

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