Thanks.

Do you complete a new service agreement for patient to sign, but that includes date insurance was retroactively effective? 

Some staff are questioning whether we can bill the ‘new’ insurance if they weren’t listed on the originally signed and dated agreement.  I think it depends on the insurance and whether you needed auth, if they give retro-auth, etc., and impact to the patient (new copays or out of pocket expenses they’d now have to pay for services provided prior to known payer change).  Does anyone have any verbiage on their initial service agreement that addresses changes in payer situation like this?

Thank you!

 

Jennifer Stark, RHIA

Health Information & Compliance Coordinator

Home Care & Hospice

Ph: 218.249.6147   Fx: 218.249.6166

915 East 1st Street
Duluth, MN 55805

aspirus.org  |  slhduluth.com

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From: medicarewkgp@list.mnhomecare.org <medicarewkgp@list.mnhomecare.org> On Behalf Of Kirchoff, Jessica L
Sent: Friday, November 15, 2024 8:45 AM
To: medicarewkgp@list.mnhomecare.org
Subject: RE: [External Mail] Retroactive Medicare?

 

We would treat it like a retro payer change. There is often a modifier you can use on the claim for a late NOA due to retro authorization according to our billing team. Jessica Kirchoff OTR/L, MBA Manager, Quality & Compliance – Home

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We would treat it like a retro payer change.

 

There is often a modifier you can use on the claim for a late NOA due to retro authorization according to our billing team.

 

Jessica Kirchoff OTR/L, MBA

Manager, Quality & Compliance – Home Health

Allina Health Home Health • Allina Health Commons

Office Phone: 612-262-7734• Mobile 612-810-4420 • Fax: 612-262-7643

Mail Route 10733 • 2925 Chicago Avenue • Minneapolis, MN 55407

Jessica.kirchoff@allina.com

 

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From: Jennifer Stark - Jennifer.Stark at aspirus.org (via medicarewkgp list) <medicarewkgp@list.mnhomecare.org>
Sent: Wednesday, November 13, 2024 10:41 AM
To: 'medicarewkgp@list.mnhomecare.org' <medicarewkgp@list.mnhomecare.org>
Subject: [External Mail] Retroactive Medicare?

 

Hello,

A question has recently come up regarding retroactive Medicare coverage.  Has anyone had a situation where a patient was admitted to service, and then Medicare was retroactively authorized? How would you handle this from a billing perspective if Medicare wasn’t on your original service agreement, NOA wasn’t submitted, etc?  

Thanks

 

Jennifer Stark, RHIA

Health Information & Compliance Coordinator

Home Care & Hospice

Ph: 218.249.6147   Fx: 218.249.6166

915 East 1st Street
Duluth, MN 55805

aspirus.org  |  slhduluth.com

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