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Certified Billing Minutes

Thursday, October 27, 2011
At the MHHA Office


  I.                 Introductions

Approx 12 members (9 present…3 or more on phone)

II.               Insurance payor discussions

a.      Blue Cross…Hospice room and board claims having issues, they are looking for a solution

b.     Medicaid – nothing new

c.      Medicare

– Non-bill visits on claims / – visit counts for therapy reassessments

some still having issues with set up, most have figured it out.

– NGS, Part A training, East Lansing on Nov. 1 – emailed info to list serve

– PEP adjustments

(update to chapter 10, 10.1.14,  Medicare Claims Processing Manual)

this was effective 8/28/11.  Everyone should read and be sure they have a good


d.     Medicare Advantage Plans

– open enrollment time (Oct. 15) – good idea to be doing eligibility checking at least

monthly during open enrollment time.

– BCN Advantage Plans – some require auths, some do not

UAW is the only BCN that should be requiring auth.  Kim VanderBand will share the sheet her rep gave her.  Dawn will email out to group.

e.      Priority Health

III.             Misc- open discussion

-Ansi 5010 (anyone testing and how?) – some have tested, some are still waiting for

their software vendors to get done testing. Testing going on now, need to be live 1/1/11

-Flu shots – Medicare roster billing had glitch.  You need to put the from & thru date

on to get it to process.  Secure Horizons is paying good.

Priority Health requires a Level II HCPC code.

-PPS Grouper for 2012 rates – Dawn will email link for grouper for others to check

2012 rates

-RAC website (

Region B: CGI

IV.            Future Topics – lots of good discussion on several things.

1)     MHHA is looking into holding a fair at the Okemos office for software vendors.  Anyone interested in seeing certain software should contact Cindy Thelen so she can make arrangements to have them there.

2)   There is some interest in having a couple of billing classes.  Talked about having a

class for beginners and also a class for “seasoned” billers.  Would also like to see them

split between HomeCare and Hospice.  Will try to put some ideas together for next mtg


V.              Next meetings – Quarterly on the 4th Thursday.

January 26th, 2012 – will do via tele-conference due to time of year.  Will ask

Mary Pfeiffer to include telephone number and id # with next agenda email.

April 26th, 2012

July 26th, 2012

October 25th, 2012



Michigan Association for Home Care
2140 University Park Drive, Suite 220
Okemos, MI 48864
Phone: (517) 349-8089 Fax: (517) 349-8090

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