I got the HealthNet rep to understand my plight so she said she would cancel her auth to avoid any issues for me so that the veteran can receive the service and we can get paid. My biggest winning question with her was “who supercedes who? Who is the authority on this?”. She didn’t really know.

From: list-manager@list.mnhomecare.org [mailto:list-manager@list.mnhomecare.org] On Behalf Of Marnie Pogreba
Sent: Tuesday, September 13, 2016 10:25 AM
To: 'billers@list.mnhomecare.org'
Subject: RE: Veteran Choice vs VA

Good luck.  We have claims from 2015 that we have an auth from the St Cloud VA for.  They denied my claims saying we needed to bill the VA Choice.  Our auth from the VA Choice did not begin until 2016.  I faxed a copy of the VA authorization and the VA Choice authorization to the St Cloud VA, so that they could see they were responsible for the payment.  They called me and said they would re-open the claims.  That was back on 05/04/16.  The VA still has not paid our claims and I just had to call them and leave a message again.

You could try billing the VA first since you do have an auth but because you also have an authorization from VA Choice they might deny it.  Minneapolis VA might be better than St Cloud.

From: list-manager@list.mnhomecare.org [mailto:list-manager@list.mnhomecare.org] On Behalf Of Salin, Tracy
Sent: Tuesday, September 13, 2016 9:58 AM
To: 'billers@list.mnhomecare.org'
Subject: Veteran Choice vs VA

I have a question hopefully you can answer about Veterans’ Choice. We admitted someone who was referred by VA. WE assessed him and admitted him and received auth from the VA for home care visits. Then today our nurse was contacted by HealthNet to give us auth under HealthNet for the same services. The VA contact I spoke to today after questioning where to bill it to said to just keep doing what we are doing and bill VA as we have auth through them. The HealthNet contact said we have to bill them because the veteran chose them. With everything going on with this program, are we able to just bypass it and work with the VA directly? Our Minneapolis VA has been great to work with these last few years. Our payment issues have decreased dramatically, and I know how to navigate to get any issues resolved. The other reason I am hesitant to bill to HealthNet is that if they find out the VA authorized it, they may cancel their auth and then we may end up with no payer.

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