Home Health & Hospice Week

Tip: The physician must document the date.

As in round 1 of Medicare's Probe & Educate claims review initiative, the face-to-face physician encounter requirement caused the most denials in round 2 as well.

Of HHH Medicare Administrative Contractor CGS's total of 4,631 denials under P&E's second round, 1,180 - 25 percent - were for F2F reasons, the MAC says in round 2 results posted to its website Jan. 29 (see story, p. 45).

Smart home health agencies will be making F2F documentation a priority, notes finance expert Dave Macke with VonLehman & Co. in Ft. Wright, Kentucky.

CGS lists these specifics in describing its F2F denial reasons:

• Actual F2F encounter document not submitted;
• Certifying physician did not document the date of the F2F encounter;
• Community physician was not identified when a physician who would not be following the patient after discharge signed the certification;
• Estimated length of skilled services was not documented in the recertification document; and
• Required elements for initial certification (initial plan of care, initial certification, initial encounter documentation) were not submitted for recertification.