Provider Update: November 13, 2019
To:ADvantage Case Management and Meal Providers
Subject:S5170 Home Delivered Meal Billing and Planned Services
Home Delivered Meal Billing
A change in the OHCA system has been made to allow Meal Providers that send out frozen or shelf-stable meals instead of daily hot meals to bill for the meals shipped versus daily billing, as noted below:
- Hot Meals – Providers should continue to bill 1 unit per day for the date of delivery.
- Frozen/Shelf-Stable Meals – Providers can now bill up to 14 units for the date the meals were shipped. This change will allow the provider to bill for the date that the service was actually provided.
Example: For 7 Frozen meals shipped on 11/12/2019, the claim would be filed for 7 units for DOS 11/12/2019 and not for 1 unit per day 11/12/2019 to 11/18/2019.
Home Delivered Meal Planned Services
The Case Manager should submit meal requests for S5170 depending on what the Member is going to receive, as follows:
Member receives hot meals (delivers daily):
Units per Frequency – 1
Frequency – Business Day (if 5 delivered per week)
Frequency – Calendar Day (if 7 delivered per week)
Member receives frozen/shelf-stable meals:
Units per Frequency – 5 (if 5 shipped per week or 10 shipped every 2 weeks)
Units per Frequency – 7 (if 7 shipped per week or if 14 shipped every 2 weeks)
Frequency - Week
*NOTE:A plan validation error will occur when the weekly frequency is used. We are working with our vendor to change this wording, please ignore the error for now if the frequency is supposed to be weekly and MSU will override.