Re: 150290 CDHC - Reconciliation of Denials/ Overpayments & Confirm Correct Invoicing: Payments 985066, 985068, 993859, 993860, 1007416, & 1007419 - [#1341955]

From
Shawntel Sousa <ssousa@thekey.com>
To
Chuck Terlesky <cterlesky@thekey.com>
CC
Marc Atkinson <collectionsteam@thekey.com>, lito.delapena@thekey.com, tt@thekey.com, michelle.kenaga@thekey.com
Date
2025-12-22 14:04:35
Folder
INBOX
--000000000000f343cc064690c6da Content-Type: text/plain; charset="UTF-8" Content-Transfer-Encoding: quoted-printable Hi, I can update these date of births but these were what the clients gave us. I wonder why they don=E2=80=99t match but we can update them. *Respectfully, * *Shawntel Sousa, LPN* Client Success Manager | TheKey Mobile: 403-305-6588 Office: 403-301-3777 On Mon, Dec 22, 2025 at 2:00=E2=80=AFPM Chuck Terlesky wrote: > Hi Marc, > > Thanks for the detailed update. Sorry for the inconvenience, but we shoul= d > postpone the meeting until Tim returns from vacation next week. Tim and I > will need to discuss the amounts we may need to write off and determine > which ones will impact my P&L. Let=E2=80=99s hold off until we can all me= et and > make the final decision on each client. I would suggest December 30th, > after 10 am MST. > > Shawntel, could you please update the care plans before next week to > include the correct birthdates? > > Thanks, > > Chuck > > > > On Mon, Dec 22, 2025 at 1:41=E2=80=AFPM Marc Atkinson > wrote: > >> Hi Chuck and Shawntel, >> >> I just got off the phone with Alberta Blue Cross to review their denials >> for DOS 11/17-11/28, amongst other matters. Please see below. Also, they >> advised that our Provider ID # is 8053, in case your office needs this. >> >> >> *Mary & Ray Albo* >> >> Reviewed the totals they short paid and confirmed they match what we hav= e >> in our system after posting their payment. The clients are responsible f= or >> the total overages seen below that are highlighted in red. >> >> >> >> *Carolyne Lewis* >> >> - ABC confirmed that the $596.89 in the client's responsibility >> - On 11/20, the client reached her maximum number of hours, causing a >> partial payment for 11/20 and no payments at all for 11/21-11/22. >> - According to ABC, this client's hours change every single month. In >> November, her hours were less than the 175.37 currently in Wellsky for h= er >> auth. This is what caused the hours overage. They suggested that we work >> with the clien't care manager to ensure that we have the correct >> authorization on file for every month moving forward. Thankfully, the ho= urs >> of 175.37 are correct for December, but we would suggest getting in touc= h >> with the care manager to confirm January's hours and to confirm every mo= nth >> after that. >> >> >> >> *Theresa Didomenicantonio* >> >> - ABC confirmed that the $136.12 is client responsibility >> - ABC claims that the client's coverage ended on 11/25 for the rest of >> the month of November. They believe the client was sent to the hospital = on >> 11/25. They will not cover a shift when the client is in the hospital, >> leading to the non-payment for DOS 11/26. >> - ABC confirmed that the client's coverage is again active, as of 12/1, >> for the hours of 39.36 that are currently on file in the Wellsky auth. >> >> >> >> *Lorraine Monette* >> >> For documentation purposes, I had ABC confirm that the $912.54 is client >> responsi

Thread (1)