Collections Question - Programs

Otter Tail County is currently using CCS on the AS400 for our collection system.  There is a push to move away from the AS400 and migrate to web-based formats.

I am wondering what programs counties are using for a collection system, what do you like/dislike about what you are using.

Thanks!

Diane Aschnewitz

Fiscal Supervisor

Otter Tail County Human Services

530 W Fir Av

Fergus Falls MN  56537

218-998-8157

daschnew@co.ottertail.mn.us

72 hour hold billing

We received a bill for a 72 hour hold.  The client had Medicare coverage and the facility received a payment.  The facility now wants us to pay the deductible and co insurance.  One of our supervisors said if they have a contract with Medicare they have to accept that payment in full.  I had asked the woman from the facility if they were suppose to accept that in full like the prepaid health plans and MA and she said no it’s different.  What do other counties do?  Our policy has been we are the payor of last resort.  If the client had Medicare we would not pay anymore and if they were not on MA at the time we would only pay what MA would have paid.

Thank you

Bobbi Sivonen

Fiscal Supervisor

Koochiching County Public Health and Human Services

MA Mileage reimbursement question

Question on MA Mileage

We are using the state RUCA formula for submitting MA transportation claims (A0090) and are combining round trips into one service line.  The problem we are running into is that we are being reimbursed only .22 even when the zip code is considered “rural”.

One suggestion we have received is to bill different service lines for each one-way trip instead of combining into a single round trip, using a modifier to indicate the return trip.  There is no modifier listed in the link below.   In the past, trips with the same service date would be rejected. 

See the MHCP Provider Manual, Transportation Services:

• Local County or Tribal Agency Nonemergency Medical Transportation (NEMT) Services Claim, Service, and Rate Information section.  This has information at the end of the section on the RUCA calculation criteria.

Has anyone else experienced this issue?  How did you modify the billing process?

Diane Aschnewitz

Fiscal Supervisor

Otter Tail County Human Services

530 W Fir Av

Fergus Falls MN  56537

218-998-8157

daschnew@co.ottertail.mn.us