Home Health & Hospice Week
HHH Medicare Administrative Contractor Deactivates PECOS Edit
Stay tuned about what to do with your claims erroneously denied by Palmetto GBA for lacking a physician enrolled in PECOS. The problem: Providers were "receiving reason code 32072 which states 'FOR HOME HEALTH CLAIMS (32X AND 33X) THE ATTENDING PHYSICIAN ON THE PECOS PHYSICIAN FILE HAS A TERMINATION DATE PRESENT AND IT IS EQUAL TO OR LESS THAN THE CLAIM FROM DATE OF SERVICE,'" Palmetto notes on its website. The solution: "This reason code edit has been deactivated," the HHH Medicare Administra-tive Contractor says. But it's unclear if Palmetto will automatically fix the claims denied in error. "Palmetto GBA will advise if provider action is necessary on those claims that were denied," it says. The edits were turned on in error in relation to instructions CMS gave its MACs regarding processing of information on physicians who opt out of Medicare, NAHC says.
Home Health & Hospice Week
- Fraud & Abuse:
Feds Train Fraud Spotlight On Home Care
Watch out for further fraud-fighting measures such as an HHA surety bond. The home care [...] - Reimbursement:
CMS Moves Full Steam Ahead On PECOS Edits
You can't use ABNs for docs lacking PECOS records, final rule says. The PECOS-related claims [...] - Compliance:
Don't Hang Up The Phone On Fraud Complaints
Your report can contribute to CMS's 'heat map.' Home care providers often voice frustration when [...] - OASIS:
Make Changes To Staff's OASIS Assessments The Right Way
Fraud case highlights important compliance aspect of OASIS. You could lose hundreds of dollars per [...] - Industry Note:
Double-Check Your CAHPS Data Submission Or Risk Payment
Don't forget, your data is now on public display. Medicare won't take any excuses when [...] - Industry Note:
HHH Medicare Administrative Contractor Deactivates PECOS Edit
Stay tuned about what to do with your claims erroneously denied by Palmetto GBA for [...] - Industry Note:
Training Webinars Will Be Available Online
Did you miss Medicare's April training sessions on the new hospice quality reporting requirement? You'll [...] - Industry Note:
Consider ABNs When Therapy Caps Apply
Home care providers that are furnishing Part B therapy services in the home should pay [...] - Industry Note:
HHAs Continue To Flub 855 Paperwork For CGS Revalidations
Home health agencies continue to have trouble with their revalidation applications for HHH MAC CGS. [...] - Industry Note:
Revised PPS Fact Sheet Addresses F2F, Therapy
Looking for a resource to help educate patients, referral sources, your own employees, and others [...] - Industry Note:
Get Hospice Discharge Coding Correct Now, Before July 1 Changes Hit, CMS Urges
CMS is reorganizing its hospice discharge coding this July 1, but you also need to [...] - Industry Note:
Hospice Partners With Michigan ACO
Wondering what your relationship with the new Accountable Care Organizations should look like? Check out [...] - Industry Note:
Looming 30% Doc Pay Cut Translates To Big Budget Reductions Coming
Gear up for some ugly Medicare budget cutting at the end of the year. It [...]
