We have billed Medicare side of MSHO and we have been successful at doing so. If billing Medicaid side then need the case manager to send in recommendation of home care form to BCBS. Not sure what the requirements are to billing Medicare side & what documents are required as it is handled by our medical records.

 

 

 

First thing. Blue Cross MSHO does require an oasis since it is a Medicare/Medicaid product. Does anyone ever bill PPS to Blue Cross MSHO? Isn’t it just per visit? If so you would then need to just get prior auth for the services.

 

 

We have a client who is currently on Medicare. Their county worker has informed us they have sent in paperwork to make them eligible for a blue cross MSHO plan. If the paperwork is approved they will be backdating this insurance change to be effective 11/01/2015 under BC PPS. The client has SN/PT/OT, how do we ensure that we can bill for everything? Do we do a D/C Oasis for 10/31 when we find out and just begin billing Blue cross then on 11/1. Do we need to have an admit visit under this new payer since Blue Cross does not required an oasis?

Do we need all new orders and a whole new chart or does everything just flow since it is a payer change from the Medicare level to the Medicare level.

 

 

 

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