Home Health & Hospice Week

Cost data will determine future payment rates, bundling.

Billing for supplies might not make a difference to your bottom line today, but it could make a good deal of difference down the road.

The Centers for Medicare & Medicaid Services and other federal agencies use home health agencies' claims and cost report data to make big decisions ranging from payment rates to supplies bundling.

HHAs' profit margins, based on their claims and cost report data, are making securing legislative relief more difficult than before profit data became available. And a new General Accounting Office report says a lack of supplies data makes unbundling of costly wound care and ostomy supplies impossible for now (see pdf of Eli's HCW, Vol. XII, No. 29, p. 226).

No Time To Submit Supplies Charges, HHAs Protest

But many busy HHAs simply don't have time to submit charges that don't make a difference to payment levels. And a supplies-billing glitch that kicked out claims with itemized supplies charges has further discouraged agencies from submitting those costs (see pdf of Eli's HCW, Vol. XII, No. 26, p. 206).

HHAs serviced by regional home health intermediary Palmetto GBA can follow new instructions on how to add supplies costs back onto claims from which they were stripped during the glitch. To make sure the cost of your supplies are accounted for, follow these instructions from the RHHI for the Direct Data Entry (DDE) system:

o Choose from the Main Menu 03-Corrections

o Locate claim adjustments and select 33-Home Health

o Pull up the claim by entering the Medicare number for the patient and the dates of service

o Type a "U" beside the appropriate claim and press Enter

o Enter the condition code D1 (change charges) on Page 1

o Add the supply line back with appropriate charges on Page 2 under the 0001 line and then correct the 0001 total charges line to include the added amounts for supplies

o Enter the adjustment reason code OT on Page 3

o F9 the claim. v