Home Health & Hospice Week

What does your MAC have to say about the reimbursement-robbing edits?

You may have thought you were OK when it came to submitting OASIS files before final claims, but are now finding that’s not the case as matching edit denials hit your doorstep. Or you may be flying along well now, but an unforeseen technical glitch around the corner could derail your OASIS compliance — taking thousands and thousands of dollars with it.

Arm yourself with knowledge of how the edits work and how to make sure you pass them by consulting these free informational resources:

• October 2016 Centers for Medicare & Medicaid Services transmittal implementing the edits: www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3629CP.pdf.
• MLN Matters articles about the edits from October: www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM9585.pdf ; and March: www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/se17009.pdf.
• Job aids and educational articles on your HHH Medicare Administrative Contractors’ websites. Check out www.cgsmedicare.com/hhh/pubs/news/2017/0617/cope3480.html for CGS. For specific web addresses for Palmetto GBA and National Government Services and additional CGS resources, email editor Rebecca Johnson at rebeccaj@eliresearch.com with “OASIS Matching” in the subject line. Palmetto, CGS, and NGS have all published recent guidance about the edits.
• Consultant Melinda Gaboury’s blog post on the topic at https://healthcareprovidersolutions.com/oasis-transmission-denials-result-adrs.