We are having the same issue, BCBS MSHO Medicare claims are consistently overpaying. They seem to be paying the HIPPS rate plus each line of service’s per-visit rate. My last phone call to the general provider call center resulted in a
reprocess all of the claims under our NPI since 010124, but I’ve not seen the result of that yet so its inconclusive whether or not that will fix anything.
If anyone else has had success in getting their Medicare BCBS MSHO claims to process correctly, please let me know. Or if you have a specific contact person that is familiar with the issue so we can add ourselves to it, (if they’ll do that),
that’d be helpful too.
We have not had late NOA penalties, though, so I can’t speak to that issue.
Thanks --
Kori Meyer
Patient Accounts Specialist
Home Health Care
915 E 1st St | Duluth, MN 55805
Phone: 218.249.6138 | Fax: 218.249.6166
Koren.Meyer@aspirus.org
From: Hanson,April <April.Hanson@PerhamHealth.org>
Sent: Friday, November 15, 2024 3:19 PM
To: billers@list.mnhomecare.org
Subject: Blue Cross MSHO Medicare claims
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the content is safe. Good afternoon, We are having trouble with our Blue Cross
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Good afternoon,
We are having trouble with our Blue Cross MSHO Medicare claims processing according to CMS pricer guidelines. Is anyone else experiencing the same issue? We also
have some that are applying penalties for the NOA's being received late. This was during the time frame that assurance was down. We have tried to submit proof of our attempted submissions in Availity. However, we were having trouble with those going through
initially. Has anyone had any luck with getting the penalty for late NOA's removed due to the assurance issue? Any guidance would be greatly appreciated. I would love to get these older claims resolved!
April Hanson
Patient Accounts
Perham Living
Ph: 218.347.1894
F: 218.347.1885
Dedicated to health and wellness throughout life.
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