This has been happening to us as well.  I now have a cheat sheet that shows which TOB we should be using based on the DOS and visit type.

 

From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Traci Olson
Sent: Friday, May 17, 2024 11:45 AM
To: billers@list.mnhomecare.org
Subject: VA-rejections at payer level

 

Anyone getting VA FFS claims rejected at the payer level for Admission date can't match invoice date? I have been trying to figure this out forever. I even called one of the nurses at the Mpls VA to see what they say and see if they had changes. She laughed and was like what? That doesn't even make sense. I said I know. When we open someone that is considered a visit, she forwarded my question onto the nurse manager and I am waiting for a call back from her. Other weird thing is the VA is paying all the other claims after the initial SOC claim. I have talked to VA Optum customer service numerous times, they are no help bc the claim hasn't even gotten to them. I ask for a sup, noone calls me back, noone is available ever. I reached out to our clearing house and the intermediary tt the payer and said that is what the rejection is and I am like it doesn't make sense. I asked if I could talk to the intermediary or payer and I get a no. I am at a loss for all our new opens. 

 

Just wanted to see if anyone else is having the same issues. 

 

Traci Olson

Regency Home HealthCare
651-488-4655 Office
651-488-4656 Fax

 

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