Home Health & Hospice Week

The last thing you need is to lose out on reimbursement because you didn't realize a patient is receiving care from another agency.

Regional home health intermediary Palmetto GBA offers this checklist to help you smoothly admit new patients -- even those transferring from somewhere else:

-- Log onto HIQH by typing "HIQH" on the main screen and entering the appropriate username and password.

-- Fill in the appropriate beneficiary information required on the first screen and hit ENTER. Be sure to enter the start of care date in the APP FIELD.

-- Review the information found on page 3 of HIQH to determine all prior home health episodes. Be sure to print out page 3 and date stamp it for the beneficiary's records. Should a situation arise regarding a billing conflict this information will be requested by Palmetto GBA.

Once you have accessed page 3 of HIQH, you are now ready to determine if the beneficiary is new to the home health benefit or in need of transferring from another home health agency.

-- If a Provider Transaction Access Number (PTAN) is found on page 3 of HIQH and the patient status is a "30," this indicates the beneficiary is still on service with another home health agency and a transfer would need to take place.

-- Follow the appropriate steps for completing a transfer. This information is found in the CMS Internet Only Manuals, Publication 100-04, Chapter 10, Publication 100-02, Chapter 7, and The RHHI Transfer Job Aide on the Palmetto GBAWeb site (www.PalmettoGBA.com/rhhi).

-- If a beneficiary-elected transfer takes place, be sure to call the current home health agency to agree upon a transfer date.

-- Transfers are indicated by using a "B" Source of Admission Code on your RAP and Final Claim in FL 15 of the UB-04 form.

If no other home health agency is listed in HIQH or if the patient status indicates a discharge then a Request for Anticipated Payment (RAP) and Final Claim should be billed using a "B" source of admission code if it falls within the same 60-day episode.

For further information on overlapping claims and transfer situations, please review the CMS Internet Only Manual at www.cms.hhs.gov/manuals  or call the Provider Contact Center at Palmetto GBA at (866) 801-5301.