Home Health & Hospice Week

Stay on top of audit requests so you're able to meet all request deadlines. Medical reviewers can retroactively deny your claims for a number of reasons -- but one that you should remedy is lack of medical documentation. You could get hit with medical review from a variety of sources these days -- Medicare Administrative Contractors, intermediaries, Program Safeguard Contractors, Zone Program Integrity Contractors (ZPICs), Recovery Audit Contractors, etc. If a medical reviewer from one of these contractors requests your medical documentation and you don't send it -- or you submit incomplete or illegible records -- your payments can be denied. Plus, money that your MAC or intermediary already sent to you can be recovered in cases of nonexistent or incomplete documentation. The Centers for Medicare & Medicaid Services recently identified the issue of incomplete documentation as a "high dollar improper payment vulnerability," and the agency issued MLN Matters article [...]