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Home Health & Hospice Week

Industry Note:

HHH MAC Ramps Up Medical Review

Published on Fri Feb 03, 2012

Medicare contractor may ask to look at 40 claims in initial probe. You're not alone if you feel like you're getting bombarded with additional development re-quests from your home health and hospice Medicare Administrative Contractor. "We have been hit hard with them," one Illinois HHA representative said in a recent Ask the Contractor Teleconference (ACT) for HHH MAC Palmetto GBA. "Is there a cap in terms of the number of claims selected in an initial probe?" asked another agency in the teleconference. "I am just wondering how many more we should be expecting." Palmetto "is conducting probe reviews on both home health and hospice services," the MAC said, according to its transcript of the ACT. "These reviews are in an effort to prevent inappropriate payments," it added. If you're on the ADR list, you may not be out of the woods yet. "Typically a service-specific probe sample is 100 and [...]
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