Yes, that is how I do it. I have the therapists give me a copy of their Eval and what they are wanting for a treatment visit amount and I send in the request for the total amount of visits including the EVAL.
I have not had a problem getting any therapies paid doing it this way.
KELLY RADER
INSURANCE BILLING SPECIALIST
HENNEPIN HOME HEALTHCARE
763-425-5959 EX. 44
From: list-manager@list.mnhomecare.org [mailto:list-manager@list.mnhomecare.org]
On Behalf Of Salin, Tracy
Sent: Wednesday, September 09, 2015 8:09 AM
To: 'billers@list.mnhomecare.org' <billers@list.mnhomecare.org>
Subject: RE: Eval coding for UCARE MDCR
My understanding is that you do not need to seek prior auth for therapies BEFORE the 1st visit. But when you seek authorization, you need to include that visit. They will always cover that one at least
but you still need to include it when requesting auth. Our biggest frustration is that you are allowed 15 NV and HHA for some plans but not for others. Then you have to constantly be looking at your UCARE clients…
From:
list-manager@list.mnhomecare.org [mailto:list-manager@list.mnhomecare.org]
On Behalf Of Kelly Rader
Sent: Wednesday, September 09, 2015 8:06 AM
To: 'billers@list.mnhomecare.org'
Subject: RE: Eval coding for UCARE MDCR
I bill therapy visits as (1) to Ucare as per their billing requirement for therapies. G0152 (PT) & G0151 (OT) for MSHO and Ucare for Seniors. S9129 (OT) & S9131 (PT) codes for Ucare Msc + and SNBC. I
do not have any problems. According to UCare policy we do not need an authorization for PT or OT evals but I have found that the EVAL visits do not get paid if there is not an auth from HSM in UCARE’s system. I request an auth for the 1 visit. HSM puts
the auth in as 4 units but I still bill 1 visit (per UCARE billing requirement) and get paid correctly.
KELLY RADER
INSURANCE BILLING SPECIALIST
HENNEPIN HOME HEALTHCARE
763-425-5959 EX. 44
From:
list-manager@list.mnhomecare.org [mailto:list-manager@list.mnhomecare.org]
On Behalf Of Mary Jonason
Sent: Tuesday, September 08, 2015 2:05 PM
To: Billers@list.mnhomecare.org
Subject: Eval coding for UCARE MDCR
What codes are you using for OT and PT evals with UCARE MDCR? We are having issues with getting our evaluations paid.
Thanks
“Whether you believe you can or cannot you are right” Anonymous
Mary Jonason
Accounts Receivable Manager
Prairie River Homecare
Phone 763-682-0665 fax 763-682-6543
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