Home Health & Hospice Week

Hospice:

Sidestep Hospice Cert Pitfalls With These 4 Tips

Pointer: Use your own docs to persuade colleagues to improve documentation.So often for hospice patients, claims denials hinge on the patient's certification or recert. Look to recent results from the Comprehensive Error Rate Testing program to help you avoid cert landmines.In the latest time period, "all CERT errors for hospice providers were related to the hospice certification/recertification," says HHH Medicare Administrative Contractor CGS in a newsletter for providers. Sometimes hospices simply failed to submit the cert to the CERT contractor. But in other cases, the cert had other problems.Example #1: For one patient, the CERT contractor found the documentation to be insufficient. The documentation "lacked the specific clinical findings and explanation of why the clinical factors supported the six month prognosis," CGS explains.The hospice under CERT review is hardly alone. "The most common problem area that we see is insufficiently documented certifications," says consultant Beth Carpenter with Beth Carpenter and [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Home Health & Hospice Week

View All