Hello,

That is correct, for Blue Plus MSHO, when billing under the Medicare portion, you do not need a prior authorization.

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>
Sent: Monday, March 11, 2024 2:17 PM
To: 'billers@list.mnhomecare.org' <billers@list.mnhomecare.org>
Subject: Blue plus MSHO auth question

**External Sender**

When a patient meets the status of medicare eligible for homebound care, do we need a prior authorization from the patient's blue plus MSHO policy for PDGM billing? Seems like I should know the answer to this question, but I guess I don't. The social worker had previously done an authorization for our patient's skilled home care, but her supervisor is telling her she shouldn't have created a prior auth for it because she meets the 'medicare eligible' condition for homebound care and she's telling her to back out the authorization.

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

This message (including any attachments) may contain confidential information. The information is intended only for the use of the individual or entity to which it is addressed. If you are not the addressee or the employee or agent responsible to deliver this e-mail to its intended recipient, you are hereby notified that any review, use, dissemination, distribution, disclosure, copying or taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this communication in error, please notify us immediately by return email and destroy all copies of this communication, including all attachments.