Billing list serve meeting 2/18 Recap
No pay RAP billing:
We discussed no pay RAPs for both medicare and advantage plans. Most everyone seems to be doing good though there is still much confusion over advantage plans and whether or not they want them and if they want them in 5 days.
Aetna payer seems to be working perfect for the no pay RAPs.
Some who were sending No Pay RAP's to Blue Plus MSHO (Medicare) were getting notice back that they did not need to send them.

Medicare Final Claims:
Some of us are already getting final claims paid by Medicare..
Interest has been expressed to ask if the MN Home Care Association can get clear answers from advantage plans on how they want claims billed for PDGM. Do they require them within 5 days? What if they are late? What do providers do? Etc...

Railroad Medicare.
Does anyone have information on whether this coverage has any different billing requirements  for home care? The thought is no but no clear understanding. We will research and follow up at March meeting.

Episode Timing:
Someone asked for clarification on early versus late episode timing when someone comes from a previous home care admission within 60 days from end of the previous home care episode. If there is not a 60 day break from last day of 60 day period then the timing is late. If providers answer this wrong on oasis, Medicare will catch it.

VA billing:
Some billers are still struggling with VA billing. We talked at length over various issues and here is some information if anyone is need help.
Bill based on the authorization letter. Non VA CCN network is Optum VA. VA network is VA. Optum payer id is VACCN. VA is 12115. If billing VA, use 32x bill type, G codes, bill units of 15 min increments, make sure auth # is on claim.
If billing Optum, you need to know if the auth says bundled or nonbundled. Bundled is PDGM billing format. Nonbundled is per visit billing format. Bundled bill type is 32x. Nonbundled is 34x. Bill using G codes, bill units in 15 min increments, and make sure auth # is on claim. If anyone is have trouble with old Triwest or VA claims, it can be immensely helpful to reach out the community care department. Bill separate claim per service as the auth # may be different for each service type. If the auth end date is different on print from Optum versus the service auth request form, use the date on the service auth request form.

Sorry:
Due to Zoom timing limitations, we were kicked off at 45 minutes. About 7-8 of the participants logged back into the original zoom meeting link and continued on. If this happens again, please just close out and go back into meeting. We apologize for the confusion. The understanding was this shouldn't happen. Hopefully we will have the meeting time fixed for the future.

Next meeting will be in March, day to be determined.

Tracy Salin
Billing Specialist
Fairview Range Home Care and Hospice
Phone: 218-262-6982
Fax: 218-262-1723