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Home Health & Hospice Week

Industry Note:

HHAs To See Outlier Relief At Last

Published on Thu Aug 02, 2012

Latest fix is successful, contractors report.Home health agencies suffering for taking on outlier patients should be able to secure correct payment for them again."A system fix was implemented and claims are now processing correctly," Home Health & Hos-pice Medicare Administrative Contractor Palmetto GBA reports on its website.Since 2010, the Medicare claims system had been incorrectly calculating the 10 percent outlier cap on HHA payments for many agencies.The fix was implemented July 20, HHH MAC NHIC says in an e-mail message to providers. Now "all HH PPS claims with dates of service January 1, 2010 and after, where the outlier limitation may have been applied in error will be reprocessed and adjustments will be automatically created."How it will work: "These adjustments will process to the provider's remittance as any other adjustment would," NHIC explains. "The bill type on these adjustments will be 32I or 33I."Most HHAs that see an outlier adjustment [...]
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