That’s what we do at Accra, as well. Payer change = discharge and new SOC.
Rita
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From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Marnie Pogreba
Sent: Wednesday, June 7, 2023 9:00 AM
To: billers@list.mnhomecare.org
Subject: RE: Payor Change
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When a patient switches from traditional Medicare to a Medicare HMO, or visa versa, a discharge from the one plan needs to take place, we use the status code 06. And a new SOC under the new Medicare plan will need to take place. It’s
a pain.
For non-Medicare, it might depend on how your EMR is set up. For us, we always have to do a discharge and then a New SOC when there is a pay source change.
Marnie
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Sent: Tuesday, June 06, 2023 11:57 AM
To: billers@list.mnhomecare.org
Subject: Payor Change
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**External Sender**
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With the recertification we are seeing payor changes in the middle of the episode. Example: SOC with Medicare on May 10, June 1st client is Ucare MSHO. I am assuming
that we are going to see these changes for the rest of the year. Need help to understand how to treat these clients for billing.
The above example we have enough visits for a LUPA. Then does Ucare need a new SOC on 6/1/23 or can we use the same Oasis from May to start an episode with Ucare.
Does it make an difference if they are MSHO VS Advantage plan?
Thanks
Nazneen Khtaoon
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