We bill UCare commercial PDGM like Medicare.  This was really strange to me as in the past commercial plans have always reimbursed per visit, but that is what our contract reads.  We now have run into issues with clients having LARGE co pays as they reimburse PDGM and not per visit.  It is also impossible to determine what to tell the client prior to services what they may owe out of pocket as we do not know the HIPPS until the SOC. 

Staci Boehmer

Home Health & Hospice Billing Manager

Direct: 952-428-7295

Main: 952-428-7295 | Fax: 952-345-8771

Email: sboehmer@lifespark.com

Lifespark – the Complete Senior Health leader
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From: Alicia Schmidt <Alicia.Schmidt@vivie.org>
Sent: Tuesday, May 13, 2025 10:38 AM
To: billers <billers@list.mnhomecare.org>
Subject: Ucare Commercial claims

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For Home Health Ucare commercial plans, I used to bill with S and T codes, but now they are stating that it needs to be G codes (their manual states this also).  My claims were denied stating it needs a hipps code (even though commercial) and now it's denying stating the HCPS codes are incorrect/missing.  When I called in to find out more information, they told me to check with my coding department.

Does anyone bill Ucare Commercial plans for home health and are able to get paid? Are you billing like Medicare?  We don't have very many claims that we bill to commercial Ucare, but none of my 2025 I have gotten to pay, so I have to be missing something from previous years.

Thanks for any assistance!

Alicia Schmidt

Manager of Revenue Cycle

Direct:

320‑759‑3340

Fax:	320‑759‑1275

2715 State Hwy 29 S Ste 103

,	Alexandria

,

MN

56308

vivie.org

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