Yes, and a letter is being sent to the client with the wrong date than what I have calculated the 20^th visit to be so it is upsetting the client in addition to me.

I was able to request auth prior to the 20^th visit now. At least it let me put it in a week before the anticipated 20^th visit. I haven't gotten a letter back yet but I am hoping because you CANNOT do a retro auth. Ugh. Every payer has more hoops to jump through every day it seems.

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 Hanson,April <April.Hanson@PerhamHealth.org>
Sent: Thursday, August 17, 2023 12:00 PM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] Re: Blue plus MSHO final denial issues

We are also having this issue luckily when they are sent back they have been paying our claims. I do give them the claim number of the NOA they processed.

We are also having issues with some of our BC MA claims denying for needing auth but the auth was not required until after the 20^th visit. Anyone else having that issue?

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: Thursday, August 17, 2023 11:56 AM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] RE: Blue plus MSHO final denial issues

We too are having our BP MSHO Final claims deny for no RAP, I then appeal them as the requirement is for a NOA. Then I get letters back from Blue Plus saying they processed correctly. We have a representative that works with our facility through our contract, after I attempt to appeal, I then notify our Rep and she is able to get them processed. It is ridiculous, as we should not have to jump through so many hoops to get our claims that were sent correctly to process and pay.

Marnie Pogreba

Home Care and Hospice

OFFICE: 218 894 8324

Fax: 218 894 8099

LAKEWOOD HEALTH SYSTEM, SENIOR CAMPUS

401 Prairie Ave NE| Staples, MN 56479

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Mortenson,Crisa
Sent: Thursday, August 17, 2023 11:41 AM
To: 'billers@list.mnhomecare.org' <billers@list.mnhomecare.org>
Subject: Blue plus MSHO final denial issues

**External Sender**

I've been having issues with my blue plus MSHO denying my final claims for no RAP, so I appeal them and include the original bulletin that states NOAs are required as of last July and they come back and pay. Now I'm having final claims being denied for being billed 'outside of contractual agreement' the description on my claim status search in availity says 'The claim contains missing or invalid information required to process the claim'. I haven't changed the way I'm billing any of these claims and those are very non-specific denials. I have called blue plus MSHO and the reps don't really have any straight answers, so they're sending back for review to let me know what exactly is wrong. Is anyone else experiencing this and have you gotten any real answers or anything paid on this strange denials?

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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