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

--000000000000a1b40b064690b756 Content-Type: text/plain; charset="UTF-8" Content-Transfer-Encoding: quoted-printable Hi Marc, Thanks for the detailed update. Sorry for the inconvenience, but we should 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 meet= 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 have > in our system after posting their payment. The clients are responsible fo= r > 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 he= r > 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 hou= rs > of 175.37 are correct for December, but we would suggest getting in touch > with the care manager to confirm January's hours and to confirm every mon= th > 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 th= e > 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 > responsibility due to exceeding the approved hours. > > > > *Thomas Chau* > > ABC confirmed that the $42.54 is client responsibility due to another car= e > agency submitting hours for 11/20 before we did > > > > *Minh Nguyen* > > ABC confirmed that the $170.15 is client responsibility due to another > care agency submitting hours for 11/20 before we did > > > > *Tho Nguyen* > > ABC confirmed that the $575.09 is clie