If they do not meet Medicare criteria, then you will bill under the MA portion, fee for service, using T codes. And you will need an authorization from the County.
|
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 2:42 PM
To: billers@list.mnhomecare.org
Subject: Re: Blue plus MSHO auth question
**External Sender**
|
So if they do not meet the requirements for medicare eligible, then should they be fee for service or can those get billed PDGM also?
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
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org> on behalf of Marnie Pogreba <marniepogreba@lakewoodhealthsystem.com>
Sent: Monday, March 11, 2024 2:35 PM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] RE: Blue plus MSHO auth question
Yes, but you will bill it PDGM, using Medicare codes and send a NOA.
|
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 2:33 PM
To: billers@list.mnhomecare.org
Subject: Re: Blue plus MSHO auth question
**External Sender**
|
But it is still billed through blue plus MSHO, correct?
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
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org> on behalf of Marnie Pogreba <marniepogreba@lakewoodhealthsystem.com>
Sent: Monday, March 11, 2024 2:29 PM
To: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
Subject: [EXTERNAL] RE: Blue plus MSHO auth question
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
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