Home Health & Hospice Week
Incorrect G Code Adjustments, National Provider Identifier Suspensions Hound Home Care Providers
A few different claims system glitches might have held up your claims, but those problems soon should be resolved without any effort on your part. Problem #1: "New billing transactions were incorrectly generating adjustments automaticallywith a 'G' as the third digit of the type of bill," HHH MAC CGS says in a message to providers. Because the system was automatically generating the adjustments, Requests for Anticipated Payment (RAPs) couldn't be adjusted," HHH MAC Palmetto GBA explains. The FISS contractor fixed the problem, but the MACs now have to identify and inactivate the G adjustments, they say. CGS will move the inactivated adjustments to status/location I B9997, it says. Palmetto GBA will suspend the claims to a manual location, SM9009, then inactivate them. CGS expects the correction process to take up to two weeks, it says. In the meantime, "the original claims should continue processing." Problem #2: Some claims have suspended incorrectly in status and location SM94G2 and other claims have rejected incorrectly with reason code 37236 or 37237. But don't worry, NPI-related edits haven't gone into place yet. Palmetto has fixed the problem causing the incorrect suspensions and rejections, and plans to process the claims in suspense status and location S M94G2 and to reprocess claims rejected with reason code 37236 or 37237 by Oct. 21, the MAC says.
Home Health & Hospice Week
- Survey & Certification:
Top Survey Changes You Can't Afford To Miss
Appendix B may not be on the CMS SOM website, but it's still in effect. [...] - Training:
9 Tips To Ace The New Survey Interview Requirement
Get out of the office to practice your employees' survey interviews. If interviews of your [...] - Hospice:
Ready, Set, Elect Your Hospice Cap Method
Choices differ for this year versus next year. At least one HHH MAC is ready [...] - Human Resources:
Run A Successful Suggestion Program
You know your workers have good ideas, but the suggestion box is always empty. Get [...] - Industry Note:
Keep Your Eye On The Congressional Super Committee
Fate for home care copay may be close at hand. Influential legislation to cut your [...] - Industry Note:
Incorrect G Code Adjustments, National Provider Identifier Suspensions Hound Home Care Providers
A few different claims system glitches might have held up your claims, but those problems [...] - Industry Note:
Obama Administration Drops Long-Term Care Insurance Initiative
Don't count on the CLASS Act to increase your home care census any time soon. [...] - Industry Note:
New Hospice ABN Required By Jan. 1
Beginning Jan. 1, hospices must use the new 2011 version of their Advance Beneficiary Notice [...] - Industry Note:
Grouper, HAVEN Updates Due To ICD-9 Codes Posted
You should have begun using updated ICD-9 diagnosis codes this month, and your grouper software [...] - Industry Note:
OIG Shines Spotlight On $1.2M Hospice Was Overpaid
More evidence that the feds are putting hospices in their oversight crosshairs: a new report [...] - Industry Note:
Don't Substitute Therapy Asst. For Home Health Aides
Don't be so quick to substitute a therapist assistant for a home health aide when [...] - Industry Note:
Long-Term Care Giant Makes Home Care Buy
Long-term care giant Kindred Healthcare Inc. has made another home care acquisition, this time in [...] - Industry Note:
Reimbursement, Regulatory Woes Cause HH Closures
Tighter Medicare and Medicaid reimbursement is causing some home care providers to close, and the [...]
