Home Health & Hospice Week
Hold Off On 56900 Claims Action
If you had ADR'd claims denied in error with reason code 56900 (not receiving medical records within 30 days), hold off on taking any action. "Any claims that were denied incorrectly for this reason will be reprocessed based on the documentation that was submitted by the provider," HHH MAC Palmetto GBA explains on its website. "A new ADR will not be generated, nor will the provider be asked to resubmit the documentation." Likewise, hold off on filing a redetermination. If medical reviewers find a problem, "the claim will be adjusted to reflect the appropriate denial reason code," Palmetto explains. "The provider will receive a Remittance Advice (RA) showing the denial reason and may follow the normal appeals process.
Home Health & Hospice Week
- Regulations:
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Hold Off On 56900 Claims Action
If you had ADR'd claims denied in error with reason code 56900 (not receiving medical [...] - Industry Note:
Avoid Common 855 Pitfalls In Sections 5 And 6
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CMS Fraud Program Crunches Data At Big Brother Levels
The Medicare program may have a closer eye on you than you think. CMS "has [...] - Industry Note:
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Texas Home Care Chain Makes Dallas Buy
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Outlier Payment Deficiencies Cripple Small Providers
Will the next claims system update fix the problem? Question: Is there anything we can [...] - Certification:
Beware F2F Documentation Signed By Residents
CMS answers about face-to-face requirements raise more questions. That face-to-face documentation you have signed by [...]
