Omg. I will share… sooo we were referred to provide OT service covered by Vet Choice. We were given verbal authorization to do so many visits. Then billing
was an issue, then I found out wee never got any of the paperwork for the auth or anything else. Then I called and called on claims being told that they were in process. 4 months later I get a denial for no auth. On further calls, a rep FINALLY notices that
there was an auth, but for a time period we were not told. Then she said that a rep had called my office and asked the person who answered the phone if the client was receiving OT service covered by VA. The girl who answered was our therapy scheduler. She
looked and saw Vet choice and VA and said yes so they said they cancelled the auth because they were told service was covered by VA. EVEN after many more phone calls where I explained that they should have asked for billing department before asking questions
like that and explained the misunderstanding by our scheduler, and I was told they would look into fixing this issue, I never got a an answer. So I FINALLY sent a grievance out and got a denial because a person at my office had told them it was covered by
VA not vet choice. Wow!!!!! So not what she told them and they definitely SHOULD have asked more questions….especialy after 15 phone calls on record from me from my office!!!!!!!!!!
From: list-manager@list.mnhomecare.org [mailto:list-manager@list.mnhomecare.org]
On Behalf Of Laura Brown
Sent: Tuesday, August 02, 2016 2:48 PM
To: billers@list.mnhomecare.org
Subject: Re: Grievance forms Health Net
What reason did they give for denying your grievance?
On Tue, Aug 2, 2016 at 2:24 PM, Salin, Tracy <tsalin1@range.fairview.org> wrote:
Just use that one. At least your getting a grievance to them. They are terribleto work with. I used
that form for my claims which worked fine but they denied my grievance…. Very frustrating.
From:
list-manager@list.mnhomecare.org [mailto:list-manager@list.mnhomecare.org]
On Behalf Of Laura Brown
Sent: Tuesday, August 02, 2016 1:16 PM
To: Billers@list.mnhomecare.org
Subject: Grievance forms Health Net
Where do I find the grievance forms for claims? I found one but it specifically states not to be used for claim related issues.
Any help?
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Laura Brown
Billing Manager
Lake Region Home Health
320-354-5858 phone
888-501-7631 fax