Home Health & Hospice Week
Beware Adjusted Claims Payment Problem
You can expect big delays to adjustment payments for some home health agency claims, thanks to a payment system glitch. The problem: When the PC Pricer changes a HIPPS code on a claim upon submission and then you adjust the claim to change the code again, the claim pays at the originally changed code, regional home health intermediary Cahaba GBA explains on its website. The solution: A fix for this issue won't be in place until December, Cahaba says. Home health agencies can either save their affected claims until then, or submit adjustments for such claims on paper claim forms, Cahaba instructs. If submitting paper forms, you'll have to "include a remark on your UB- 04 adjustment stating that the adjustment is due to the HIPPS recoding issue." Submitting the paper form may not gain you much, however. HHAs must "allow up to 45 days for the adjustment to be entered," Cahaba says.
Home Health & Hospice Week
- Fraud & Abuse:
ZPICs Take Down Home Care Providers
You might be next on the fraud contractors' hit list, experts warn. You could be [...] - Reimbursement:
Therapy, Outliers Catch ZPICs' Eye
Zone Program Integrity Contractors use the blanket term of "aberrant billing" to describe how they [...] - Audits:
Texas HHA Faces Closure Based On 40 Claims
When a ZPIC knocks on your door, you're already in trouble. If you aren't taking [...] - Case Study:
Homebound Status Trips Up Audited HHA
If your patient is leaving the home, you'd better show it takes a great and [...] - Hospice:
Know Your Care Plan Duties For Hospice Patients In Nursing Homes
Avoid survey troubles with this expert advice. If you're confused over how to comply with [...] - Industry Notes:
Watch Out For Pre-Pay Review For Test Strips
Medicare wastes $50 million on high-utilization test strips, OIG says. If you supply blood glucose [...] - Beware Adjusted Claims Payment Problem
You can expect big delays to adjustment payments for some home health agency claims, thanks [...] - Get Ready For PECOS Informational Edits.
Starting next month, you'll find out how big of a bite the PECOS requirement is [...] - OSC Snafu Stalls Hospice Reimbursement.
A payment system glitch could be holding up your hospice claims, but a temporary solution [...] - Congress To Hold Competitive Bidding Hearing
- Work ICD-10 Costs Into Your Budget
You'd better start figuring ICD-10 transition costs into your ever-shrinking budget. "The October 1, 2013 [...] - September Last Month To Avoid CAHPS Pay Cut
This month is your last chance to get on the CAHPS train and avoid a [...] - Examine Male Patients For Cognitive Impairment
You may want to look at your male patients a little more critically when filling [...] - Former HHA Secretary Pleads Guilty To Embezzling
Keep your friends close and your enemies closer -- but sometimes it's hard to tell the [...]
