I wanted to bring this forward and let everyone know what we are now finding out regarding Health Net billing.  I have copied our emails below from Michelle Foley, marked first and second.   They “say” their system is prepared to process claims in a PPS format.

 

I am beyond words……………..

 

FIRST EMAIL:

I just wanted to follow-up with you to give you the latest information on

the Home Health payments for the Veteran's Choice Program.   I am writing

to confirm HNFS will pay Medicare certified home health agencies using a prospective payment system (PPS) modeled on Medicare’s plan. Medicare certified billing is managed in 60-day-care episodes, allowing home health agencies to receive two payments of 60 percent and 40 percent, respectively, per 60-day cycle. This two-part payment process is repeated with every new cycle, following the patient’s initial 60 days of home health care.

 

HNFS does not require an Outcome and Assessment Information Set (OASIS); however, providers must submit an initial claim, also called a Request for Anticipated Payment (RAP) and a final claim.

 

As this complex and constantly changing program continues to grow and move forward, we look forward to partnering with all providers interested in supporting our nations veterans.

 

Thank you for your continued patience as we work to improve our mutual goal in increasing access to care for our veterans.

 

Please let me know if you have any questions.

 

SECOND EMAIL:

 

Health Net wanted to make sure that providers clearly understood the billing and payment program requirements for all Home Health Providers

under the rules noted below.   We are asking that Home Health providers

that have not billed with the Medicare format in the past, start using it

immediately.   In addition,  any prior claims should be submitted /

resubmitted as corrected claims in this manner.

 

Let me know if you have any other questions.

 

Thanks

 

Michelle Foley

Provider Network Manager

Health Net Federal Services

Phone:  (612) 759-8595

michelle.x.foley@healthnet.com

 

 

Mary Jonason

Accounts Receivable Manager

Prairie River Homecare

 Phone 763-682-0665  fax 763-682-6543

 

This e-mail message contains a communication from a HEALTH CARE PROVIDER, which is communication that is strictly CONFIDENTIAL and intended soley for the use of the addressee. Any non-addressee is prohibited from reading, dissemintating, distributing, or copying the communication contained herein. If you are in possession of this communication in error, please notify the sender by telephone immediately at 763-682-0665. Thank you.