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

----==_mimepart_694efb6a5dde5_2558884e094627854b0 Content-Type: text/plain; charset=UTF-8 Content-Transfer-Encoding: quoted-printable Hi Shawntel, We wanted to bring up some possible authorization hours = discrepancies for 5 CDHC clients. I found these while working through the= unapplied funds on CDHC's account to confirm why we have these unapplied= funds and to confirm why they overpaid on 5 shifts. Please see below. = May you please review these and then confirm if your office needs to re= ach out to the clients to confirm their current hours coverage? After spe= aking with the CDHC last week, we found that some clients have changing a= mounts of approved hours every month.=C2=A0 1. Alan (William) Dalglie= sh: CDHC overpaid by 4.21 hours as of DOS 11/10 2. Marie Hillier: CDHC o= verpaid by 2.85 hours as of DOS 11/5 3. Fred (Gottfried) Asbjornhus: CDH= C overpaid by 1.75 hours as of DOS 11/21 4. Hafiz Mohammed: CDHC overpai= d by 0.93 hours as of DOS 11/23 5. Henry "Hank" Benoit: CDHC overpaid by= 1.31 hours as of DOS 11/23 Thank you! Regards, Marc Atkinson= Senior Client Account Specialist Customer Contact & Collections Center= 866-226-1702 - Main Line 239-264-1290 - Direct billing@thekey.com =0D= =0D On=0D Mon, 22 Dec at 3:41 PM=0D , Marc Atkinson = wrote:=0D =0D =0D Hi Chuck and Shawntel, =0D =0D 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. = =0D =0D =0D Mary & Ray Albo =0D =0D 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 = for the total overages seen below that are highlighted in red. =0D =0D =0D =0D =0D Carolyne Lewis =0D =0D - ABC confirmed that the $596.89 in the client's responsibility =0D - On 11/20, the client reached her maximum number of hours, causing a pa= rtial payment for 11/20 and no payments at all for 11/21-11/22.=C2=A0 =0D= - According to ABC, this client's hours change every single month. In No= vember, her hours were less than the 175.37 currently in Wellsky for her = 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 authoriz= ation on file for every month moving forward. Thankfully, the hours of 17= 5.37 are correct for December, but we would suggest getting in touch with= the care manager to confirm January's hours and to confirm every month a= fter that. =0D =0D =0D =0D =0D Theresa Didomenicantonio =0D =0D - ABC confirmed that the $136.12 is client responsibility =0D - ABC claims that the client's coverage ended on 11/25 for the rest of t= he 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, l= eading to the non-payment for DOS 11/26. =0D - ABC confirmed that the clie