Home Health & Hospice Week
HHH MAC Denies Hospice Claims With Vague Diagnoses As Non-Terminal
Don't submit a claim with one of these diagnoses, unless your documentation thoroughly backs it up -- Debility, Alzheimer's disease, and Chronic Airway Obstructions. HHH Medicare Ad-ministrative Contractor CGS is continuing a widespread review of hospice claims with these diagnoses, it says on its website. In a probe review that ran from October 2011 through March 2012, CGS denied most claims for failing to show the terminal prognosis or for certifications that were missing, incomplete or not timely, the MAC says. Hospices also failed to submit documentation at all in response to the ADR. Reminder: "The patient's appropriateness for the hospice benefit must be clearly supported in the medical record from admission and throughout the hospice care provided," CGS tells hospices. Look to local coverage decisions for tips on improving documentation of the terminal prognosis, the MAC adds.
Home Health & Hospice Week
- Fraud & Abuse:
OIG Slams HHAs For Inappropriate Billing
Is a moratorium in the industry's future?Home health agencies' lives could get even harder if [...] - Compliance:
Take These 4 Steps To Minimize Compliance Risk With OIG Stats
Where do you stand on these 6 risk factors?In an unprecedented move, the OIG has [...] - Education:
Get Training On Coding Crucial To Your Reimbursement, Compliance Record
Plus: Learn how to negotiate the hospice-nursing home minefield and protect yourself against HIPAA pitfalls. [...] - Tool:
Benchmark Yourself Against These 6 Factors
\"These six measures of questionable billing indicate potential fraud,\" the HHS Office of Inspector General [...] - Industry Note:
Profits Fall For Publicly Traded Home Care Chains
One company bucks the trend with increased income compared to last year.The 2.3 percent Medicare [...] - Audits:
RAC Posts Painful HHA Audit Topic
Brace for complex medical review based on medical necessity and eligibility.Get ready to feel the [...] - Industry Note:
Court Highlights Hospice Beneficiary Appeal Process
Hospices may have to cover more drugs and services they don't approve, thanks to a [...] - Industry Note:
HHH MAC Denies Hospice Claims With Vague Diagnoses As Non-Terminal
Don't submit a claim with one of these diagnoses, unless your documentation thoroughly backs it [...] - Industry Note:
Use This New Interactive Map From CMS To Find Your Compliance Bearings
Do you find the alphabet soup of Medicare contractors who deal with your payment and [...] - Industry Note:
Former Miami HHA Owner Pleads Guilty To Fraud
A former Miami home health agency owner has pled guilty to a $42 million Medicare [...] - Industry Note:
Hospice Medical Director Indicted In Philly
Hospice medical directors are not out of reach of the long arm of the law. [...] - Industry Note:
Hospices Continue Trend Of Opening Facilities From Coast To Coast
The number of hospice facilities seems to be increasing as fast as the feds' scrutiny [...]
