That is tricky and I do not think there is a good solution. The patient would have needed a new SOC under Blue Plus MSHO Medicare, and I don’t see how you could go back and do that now. If she still meets Medicare criteria, my thought
is you would want to do a new SOC as soon as possible under the Blue Plus MSHO Medicare. My other thought is that you would want to talk to the County about the visits your client received from 03/01 until now, to see if they could at least put in an authorization
for those under the MA portion, since it is too late to bill under the Medicare portion.
Unless someone else has better advice.
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Marnie Pogreba Home Care and Hospice
OFFICE:
218 894 8324 Fax:
218 894 8099 LAKEWOOD HEALTH SYSTEM 49725 County 83| Staples, MN 56479 |
From: billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Edel, Erin
Sent: Wednesday, July 03, 2024 2:17 PM
To: billers@list.mnhomecare.org
Subject: RE: Traditional Medicare to BluePlus Medicare
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**External Sender**
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Yes and yes on 3/1/2024
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Marnie Pogreba
Sent: Wednesday, July 3, 2024 2:07 PM
To: billers@list.mnhomecare.org
Subject: RE: Traditional Medicare to BluePlus Medicare
Is it Blue Plus MSHO?
And did they just recently retro her for that?
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Marnie Pogreba Home Care and Hospice
OFFICE:
218 894 8324 Fax:
218 894 8099 LAKEWOOD HEALTH SYSTEM 49725 County 83| Staples, MN 56479 |
From:
billers@list.mnhomecare.org <billers@list.mnhomecare.org>
On Behalf Of Aaseth, Amber
Sent: Wednesday, July 03, 2024 1:13 PM
To: billers@list.mnhomecare.org
Subject: Traditional Medicare to BluePlus Medicare
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**External Sender**
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We have a question that we are hoping you can help with. We have a client that we have been providing skilled home care services to. We had been billing her services under traditional Medicare. We recently were informed that this client
applied for medical assistance and has been approved for the EW program through BluePlus which started 3/01. We reached out to CMS Home Health Quality Help Desk to ask for assistance in determining how we should handle our OASIS and orders since we are 3
months out. It was suggested that we reach out to the payer to find out if the new payer, requires a new start of care with new orders and a new OASIS, back dated to 3/01. We have current orders, however on our OASIS it lists the pay source as Medicare. (see
response below)
Thank you for your inquiry.
Different States, different payers, and different agencies have varying responses to payer change situations, so we usually find it most effective to ask, “Does the new payer require a new
SOC?" HHAs usually can work their way through what they need to do if they answer this question.
We would be billing BluePlus Medicare because the client is receiving skilled nurse visits for wound care and is homebound.
We have tried reaching out to BluePlus but have yet to receive an answer.
Thank you for any assistance you can provide.
Amber Aaseth RN, BSN, PHN
Director
Steele County Public Health
635 Florence Ave
Owatonna, MN 55060
507-444-7650
Amber.aaseth@steelecountymn.gov
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