----==_mimepart_6949ad052c6ca_1f6be7939c044072896 Content-Type: text/plain; charset=UTF-8 Content-Transfer-Encoding: quoted-printable Hi Chuck and Shawntel, I just got off the phone with Alberta Blue Cro= ss to review their denials for DOS 11/17-11/28, amongst other matters. Pl= ease see below. Also, they advised that our Provider ID # is 8053, in cas= e 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 for the total overage= s 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 pay= ment for 11/20 and no payments at all for 11/21-11/22.=C2=A0 - 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 her auth. This i= s what caused the hours overage. They suggested that we work with the cli= en't care manager to ensure that we have the correct authorization on fil= e for every month moving forward. Thankfully, the hours of 175.37 are cor= rect for December, but we would suggest getting in touch with the care ma= nager to confirm January's hours and to confirm every month after that. = Theresa Didomenicantonio - ABC confirmed that the $136.12 = is client responsibility - ABC claims that the client's coverage ended o= n 11/25 for the rest of the month of November. They believe the client wa= s sent to the hospital on 11/25. They will not cover a shift when the cli= ent 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 tha= t the $912.54 is client responsibility due to exceeding the approved hour= s. Thomas Chau ABC confirmed that the $42.54 is client re= sponsibility due to another care agency submitting hours for 11/20 before= we did Minh Nguyen ABC confirmed that the $170.15 is cli= ent responsibility due to another care agency submitting hours for 11/20 = before we did Tho Nguyen ABC confirmed that the $575.09 i= s client responsibility due to another care agency submitting hours for 1= 1/20 & 11/25-11/28 before we did Edward Grantham ABC advi= sed that they overpaid for the month of November by 1.47 hours, leading t= o the short payment of $50.03, which they confirmed is client responsibil= ity due to the overpayment of hours Irene Huber - ABC adv= ised that the client's hours were cut back every month starting in Septem= ber. - ABC confirmed that the client's hours in November were less than = the 40.15 we have on the Wellsky auth, leading to the short payment of $1= 31.70 for client responsibility - ABC advised that we need to get in tou= ch with the client'