Fwd: Anthem coverage/payment question

Will Reid
Partner
* Please note my email has changed: *
wreid@thekey.com <https://brand.thekey.com/esg/wreid@thekey.com>
513-707-2304
TheKey.com <https://www.thekey.com/>
[image: TheKey] <https://homecareassistance.com/>


---------- Forwarded message ---------
From: Alejandro Aponte <aaponte@thekey.com>
Date: Thu, Sep 5, 2024 at 2:47 PM
Subject: Re: Anthem coverage/payment question
To: Will Reid <wreid@thekey.com>
Cc: Jeannie Ortiz <jeannie.ortiz@thekey.com>, Ali Puckett <
apuckett@thekey.com>, Cheryl Jeffers <cheryl.jeffers@thekey.com>, Steve
Sudberry <ssudberry@thekey.com>, Denny Roebel <denny.roebel@thekey.com>


Hello Will,

I found a claims phone# online for BCBS Medicare Advantage plan and got
passed around a bit, but no one could really seem to assist with the
question of what they need in order to process a claim. They did ask for
our Medicare provider ID#, which I explained we do not have, which did not
seem to get me much further than an initial phone call introducing myself
and what I wanted to investigate further with them.

I found this document online which lists the claims requirements, and from
what they list, we cannot provide.


[image: image.png]



[image: image.png]



Regards,
*Alejandro Aponte*
Finance Onboarding Analyst III
*Please note my email has changed:*
aaponte@thekey.com <https://brand.thekey.com/esg/aaponte@thekey.com>
408 479-8654
TheKey.com <https://www.thekey.com/>
[image: TheKey] <https://homecareassistance.com/>


On Thu, Sep 5, 2024 at 2:36 PM Will Reid <wreid@thekey.com> wrote:

> Do we have an update on this?
>
> Thanks
>
>
> Will Reid
> Regional Director
> * Please note my email has changed: *
> wreid@thekey.com <https://brand.thekey.com/esg/wreid@thekey.com>
> 513-707-2304
> TheKey.com <https://www.thekey.com/>
> [image: TheKey] <https://homecareassistance.com/>
>
>
> On Tue, Sep 3, 2024 at 4:24 PM Jeannie Ortiz <jeannie.ortiz@thekey.com>
> wrote:
>
>> I understand. Let's make a call to confirm if they do take The Key Home
>> Health as a provider. We'll get back to you.
>>
>> On Tue, Sep 3, 2024 at 4:16 PM Ali Puckett <apuckett@thekey.com> wrote:
>>
>>> Thank you both for the clarification. It's just odd that two different
>>> leads called in on the same day and said we are on an online list for
>>> private homecare that it's fully covered by Anthem for up to 30 hours a
>>> week. Seems like a great profit stream if we can make it work. We also may
>>> need to update some marketing information with them if we cannot provide
>>> this service.
>>>
>>> On Tue, Sep 3, 2024 at 4:09 PM Jeannie Ortiz <jeannie.ortiz@thekey.com>
>>> wrote:
>>>
>>>> Alejandro, you are correct. What we can do on our end is contact them
>>>> directly and confirm.
>>>>
>>>> On Tue, Sep 3, 2024 at 2:14 PM Alejandro Aponte <aaponte@thekey.com>
>>>> wrote:
>>>>
>>>>> Hello Ali,
>>>>>
>>>>> To my knowledge, this is not something we support (BCBS Medicare
>>>>> Advantage plan). I am including my Manager here as well to see if they need
>>>>> to weigh in.
>>>>>
>>>>> Since this is not something we support, we do not know how the billing
>>>>> process works unfortunately. Most of these plans or coverages
>>>>> require diagnostic codes / procedure codes which we cannot supply on our
>>>>> invoices. If Anthem requires anything outside of just our invoices and care
>>>>> notes like we supply for our LTC clients, this can lead to frustration on
>>>>> the clients end.
>>>>>
>>>>>
>>>>> Regards,
>>>>> *Alejandro Aponte*
>>>>> Finance Onboarding Analyst III
>>>>> *Please note my email has changed:*
>>>>> aaponte@thekey.com <https://brand.thekey.com/esg/aaponte@thekey.com>
>>>>> 408 479-8654
>>>>> TheKey.com <https://www.thekey.com/>
>>>>> [image: TheKey] <https://homecareassistance.com/>
>>>>>
>>>>>
>>>>> On Fri, Aug 30, 2024 at 10:59 AM Ali Puckett <apuckett@thekey.com>
>>>>> wrote:
>>>>>
>>>>>> Alejandro-
>>>>>>
>>>>>> I received a new lead call today who was referred from Anthem BCBS
>>>>>> Medicare Advantage plan. They said we are on their list of providers she
>>>>>> received for home care. She said her husband, who is only 64, qualifies for
>>>>>> up to 35 hours a week of private homecare. She is not comfortable with
>>>>>> paying our rate in advance and being reimbursed however, much like long
>>>>>> term care insurance payment plans.
>>>>>> Can you help me understand how this program and payment plan works?
>>>>>> She hasn't received an answer from Anthem on her end yet.  Is there any way
>>>>>> we can bill Anthem directly? I have not utilized this before but think this
>>>>>> could be a fantastic, long term client if we can make this work for the
>>>>>> family with the payment arrangement. I told her I'd email her back once I
>>>>>> understood how our billing dept handled this.
>>>>>>
>>>>>> Thank you in advance-
>>>>>>
>>>>>> --
>>>>>> *Ali Puckett, CDP*
>>>>>> General Manager-Cincinnati
>>>>>> apuckett@thekey.com
>>>>>> cell: 513-390-0905
>>>>>> office: 513-891-2273 option 3
>>>>>> *Please review us on Facebook or Google!*
>>>>>> h <https://www.facebook.com/TheKeyCincinnati>ttps://www.facebook
>>>>>> .com/TheKeyCincinnati
>>>>>> Click here
>>>>>> <https://www.google.com/search?hl=en-US&gl=us&q=TheKey+-+Formerly+Home+Care+Assistance,+7712+Montgomery+Rd,+Cincinnati,+OH+45236&ludocid=14928820858993837079&lsig=AB86z5Vop6FtX1qJtE4piAMefKIX#lrd=0x884053254cdeea23:0xcf2dd37997c50417,3>
>>>>>> for Google Review
>>>>>> [image: TheKey]
>>>>>> <https://www.google.com/search?hl=en-US&gl=us&q=TheKey+-+Formerly+Home+Care+Assistance,+7712+Montgomery+Rd,+Cincinnati,+OH+45236&ludocid=14928820858993837079&lsig=AB86z5Vop6FtX1qJtE4piAMefKIX#lrd=0x884053254cdeea23:0xcf2dd37997c50417,3>
>>>>>> <https://www.google.com/search?hl=en-US&gl=us&q=TheKey+-+Formerly+Home+Care+Assistance,+7712+Montgomery+Rd,+Cincinnati,+OH+45236&ludocid=14928820858993837079&lsig=AB86z5Vop6FtX1qJtE4piAMefKIX#lrd=0x884053254cdeea23:0xcf2dd37997c50417,3>
>>>>>>
>>>>>
>>>>
>>>> --
>>>>
>>>> Thank You,
>>>>
>>>> *Jeannie Ortiz*
>>>> Finance Onboarding and Experience Manager
>>>>
>>>> *jeannie.ortiz@thekey.com <jeannie.ortiz@thekey.com>*
>>>>
>>>> *Phone:* 754.231.4471  | *Fax:* 954.622.0662
>>>>
>>>> 5450 NW 33
>>>> <https://www.google.com/maps/search/5450+NW+33?entry=gmail&source=g>rd
>>>> Ave. Ste. 106, Fort Lauderdale, FL 33309
>>>>
>>>> *TheKey.com <https://www.thekey.com/>*
>>>>
>>>>
>>>>
>>>>
>>>>
>>>>
>>>>
>>>
>>>
>>> --
>>> *Ali Puckett, CDP*
>>> General Manager-Cincinnati
>>> apuckett@thekey.com
>>> cell: 513-390-0905
>>> office: 513-891-2273 option 3
>>> *Please review us on Facebook or Google!*
>>> h <https://www.facebook.com/TheKeyCincinnati>ttps://www.facebook
>>> .com/TheKeyCincinnati
>>> Click here
>>> <https://www.google.com/search?hl=en-US&gl=us&q=TheKey+-+Formerly+Home+Care+Assistance,+7712+Montgomery+Rd,+Cincinnati,+OH+45236&ludocid=14928820858993837079&lsig=AB86z5Vop6FtX1qJtE4piAMefKIX#lrd=0x884053254cdeea23:0xcf2dd37997c50417,3>
>>> for Google Review
>>> [image: TheKey]
>>> <https://www.google.com/search?hl=en-US&gl=us&q=TheKey+-+Formerly+Home+Care+Assistance,+7712+Montgomery+Rd,+Cincinnati,+OH+45236&ludocid=14928820858993837079&lsig=AB86z5Vop6FtX1qJtE4piAMefKIX#lrd=0x884053254cdeea23:0xcf2dd37997c50417,3>
>>> <https://www.google.com/search?hl=en-US&gl=us&q=TheKey+-+Formerly+Home+Care+Assistance,+7712+Montgomery+Rd,+Cincinnati,+OH+45236&ludocid=14928820858993837079&lsig=AB86z5Vop6FtX1qJtE4piAMefKIX#lrd=0x884053254cdeea23:0xcf2dd37997c50417,3>
>>>
>>
>>
>> --
>>
>> Thank You,
>>
>> *Jeannie Ortiz*
>> Finance Onboarding and Experience Manager
>>
>> *jeannie.ortiz@thekey.com <jeannie.ortiz@thekey.com>*
>>
>> *Phone:* 754.231.4471  | *Fax:* 954.622.0662
>>
>> 5450 NW 33
>> <https://www.google.com/maps/search/5450+NW+33?entry=gmail&source=g>rd
>> Ave. Ste. 106, Fort Lauderdale, FL 33309
>>
>> *TheKey.com <https://www.thekey.com/>*
>>
>>
>>
>>
>>
>>
>>
>