No one gets it!  I thought back, a few months ago, when they told us our claims have “processed” to the point of awaiting Medicare pricing, that they meant they were waiting on LUPA rates to pay per visit.

 

I am wondering how agencies are handling doing an OASIS on folks who were clients prior to changing over to Health Net.  We are ultimately unable to encompass all visits within the OASIS / PPS episode because of the way dates of certifications land and when the client starts with Health Net.  We are also only going back a few months as it becomes too difficult to recreate OASIS, even with Omaha completed.  In the end we are writing off a great many visits just because it is next to impossible to correctly get all services in the neat little PPS episode.

 

Any thoughts or guidance on how others are handling this change of format and remaining as compliant as possible would be great!!!

 

Tina Tomberlin

Billing Coordinator / Hospice Volunteer Coordinator

Mille Lacs Health System

Home Care / Hospice

Direct - 320-532-2807

Fax – 320-532-4325

ttomberlin@mlhealth.org

 

 

From: list-manager@list.mnhomecare.org [mailto:list-manager@list.mnhomecare.org] On Behalf Of Laura Brown
Sent: Friday, July 22, 2016 2:40 PM
To: Billers@list.mnhomecare.org
Subject: LUPA claims

 

Does anybody know how they are going to handle LUPA claims? Have they even addressed that possibility? Several of our VA clients have SN every other week or once a month, and since it is nursing only being sent to HealthNet, these will show as LUPA when creating the final 60 day episodes.

 

I still don't get it. Sorry

 

--

Laura Brown

Billing Manager

Lake Region Home Health

320-354-5858 phone

888-501-7631 fax



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