I am also in the process of setting this up as an episodic payor, following the Medicare guidelines, without the OASIS.
Jo Ann Girtz
CHI Health at Home
Home Health and Hospice
4816 Amber Valley Parkway
Fargo, ND 58104-8404
Phone (701) 237-8133 / Fax (701) 237-8188
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From: list-manager@list.mnhomecare.org [mailto:list-manager@list.mnhomecare.org]
On Behalf Of Laura Brown
Sent: Friday, July 22, 2016 3:21 PM
To: billers@list.mnhomecare.org
Subject: Re: LUPA claims
CAUTION: This email is not from a CHI source. Only click links or open attachments you know are safe.
We are going back and redoing the last OASIS or ROFU that we have for VA and changing episode to "early" instead of "N/A" and adding their Medicare number and making sure we have "zero" or the number of therapies in the therapy question.
This is the only way to create an episode in Home Solutions /Sansio software. Luckily when we switched software companies we had to do OASIS on all clients since there weren't any other options, like a general assessment. We are still trying to make sense
of it, but feel like it is hopeless. We have also created a new payer for HealthNet that is an episodic payer.
Any other input would be greatly appreciated.
On Fri, Jul 22, 2016 at 2:52 PM, Tina Tomberlin <ttomberlin@mlhealth.org> wrote:
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
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
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Laura Brown
Billing Manager
Lake Region Home Health
320-354-5858 phone
888-501-7631 fax