Home Health & Hospice Week

A recent question-and-answer session with Palmetto GBA revealed helpful advice from a panel of Medicare experts. Facilitators Tammy Tucci, Mary Lynn Stillinger, Sharon Briggman, Charlene Craven and Marilyn Jeske answered audience questions at the Jurisdiction 11 Home Health and Hospice Ask-the-Contractor Teleconference (ACT). Here are two of the questions that came up.

Question: The hospice admitted a dual-diagnosis patient in a local skilled nursing facility, although the patient is still receiving care for a diagnosis not related to the hospice diagnosis. Would the SNF or the hospice bill Medicare for the room-and-board charges?

Answer: "The hospice and SNF should first share their plans of care (POC). If the hospice and the SNF agree that their diagnoses are different and the SNF treatment is unrelated to the hospice care, the SNF would bill for the room and board on their nonrelated claim. The SNF claim would have a condition code 07 for ‘treatment of nonterminal condition for hospice patient’ in order for the SNF claim to process in the system."

Question: We need a current letter from Medicare that confirms to our auditors that we are in fact still actively enrolled in Medicare and receiving funding for services rendered. We have been attempting to obtain this contract for several weeks.

Answer: "Palmetto GBA’s Provider Enrollment department will be happy to forward a copy of the provider’s Medicare tie-in notice to demonstrate that they are in fact a Medicare provider in good standing."

Note: The next ACT is scheduled for Tuesday, Jan. 8, 2013 at 2:00pm ET and will cover Medical Review Documentation.