Medical Billing Forum
Billing => Billing => : heritagechc March 25, 2020, 12:09:48 PM
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I am the medical biller for a Home Health Agency located in Ohio. Has anyone working in home health had success billing Aetna Advantra after 1/1/20? I have sent my claims using type of bill 321, 322, 323, and 324, just as I always have. All of my claims are being denied and when I contacted them, I was told that it's because of the type of bill. Do they now need to be billed using a 329 like a Medicare Final Bill? Also, we used to bill by month. Do the claims now need to be sent episodically? Our agency has not been paid on any Advantra claims since 1/1/20. Any help would be appreciated! Thank you!
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I have not billed for this, however I thought I would try to give a suggestion. If you have an example of a claim prior to 1/1/20 that paid with the same TOB that is now being denied, I would call and give them both examples. Then ask them to point me to whatever documentation they have that explains whatever change they implemented on 1/1/20. If they were paying the claims prior to 1/1/20 with the same information, then they must have implemented a change and they need to direct you to whatever info they have on that change.
Good luck!