Home Health & Hospice Week
Brace For Claims Rejections, Adjustments Due To Hospitals
Get ready for your reimbursement reconciliation process to get more confusing. Starting Jan. 1, the Medicare claims system will reject home health agency claim items that contain dates that overlap with an inpatient stay.
Old way: Currently, the Medicare system rejects claims with overlapping dates only when the hospital submitted its claim first, notes the Centers for Medicare & Medicaid Services in CR 8699 issued Aug. 1. And the system hasn’t been checking inpatient days that occur in a swing bed.
New way: CMS is correcting those oversights, which came to light through the HHS Office of Inspector General’s 2012 report on questionable HHA billing. The system will compare incoming facility claims against home health claims. "If any home health visit dates are found to fall within the inpatient claim dates, the contractor shall …create an adjustment to the home health claim and reject the line items for any visits," CMS says in the CR online at www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3005CP.pdf.
Home Health & Hospice Week
- OASIS:
Stay On Top Of OASIS-C1 Prep As New Year Approaches
Don’t forget to listen to CMS’s OASIS-C1 call Sept. 3. The diagnosis code M items [...] - Hospice:
Gear Up For New 5-Day NOE Deadline
Notices of Termination/Revocation also subject to the new time limit. Hospices will have their work [...] - Regulations:
CMS Relents On Exceptions To NOE Filing Deadline
Hint: An IT meltdown will not qualify you for a filing deadline exception. CMS got [...] - Reimbursement:
Hospice Rates Will Increase 1.4% In October
Sequestration reductions likely to continue to harm hospices’ bottom lines. Hospices can count on a [...] - Industry Note:
Earnings Up For Publicly Reported Chains
Home care execs praise PPS proposed rule face-to-face provisions. This quarter’s round of earnings reports [...] - Industry Note:
Review Rules For Claims Spanning ICD-10 Start Date
October 2015 is now officially the new ICD-10 implementation date. The Department of Health and [...] - Industry Note:
Brace For Claims Rejections, Adjustments Due To Hospitals
Get ready for your reimbursement reconciliation process to get more confusing. Starting Jan. 1, the [...] - Industry Note:
RAP Payments For Managed Care Patients History
You’ll no longer receive RAP payments from fee-for-service Medicare for Medicare Ad-vantage patients starting Jan. [...] - Industry Note:
New Study Blasts For-Profit Home Care Providers
The longstanding tension between for-profit and non-profit home care providers has been stepped up thanks [...] - Industry Note:
Excluded Employee Costs Another HHA 6 Figures
If you don’t have an extra $320,000 rattling around in your pocket, you’d better step [...] - Industry Note:
Submit PPS Rule Comments Before It's Too Late
You’ve only got a few weeks left to give CMS your two cents on the [...] - Industry Note:
Non-Profit Hospices In Virginia To Merge
Two hospices in Virginia plan to merge. The Hospice of the Piedmont in Charlottesville and [...]
