Home Health & Hospice Week

Industry Note:

Invite Docs To Probe & Educate F2F Call, MAC Encourages

Don’t miss out on your chance for education straight from the horse’s mouth under the Probe & Educate review process focused on face-toface compliance — and invite the physician in the case too. “Palmetto GBA is offering one-on-one education as a follow-up to the Home Health Probe and Educate review,” the Medicare Administrative Contractor says in a message originally posted in February but recently redistributed — perhaps in reaction to provider confusion on the matter.

How it works: You will receive an individual decision letter for each claim that has an error, Palmetto explains. “Claims without an error, will not receive a letter. A final results letter will be sent after all claims have completed the review.”

That final letter will tell you your error category (No or Minor Concerns with 0 to 1 errors, or Moderate/Major Concerns with 2 to 5 errors) and will tell you whether your P&E probe is done (former category) or will repeat (latter category). Both letters will offer one-on-one education for any claims denials, Palmetto says.

“HHAs should not request one-on-one education until the review of the five claims is completed and they have received their final results letter,” Palmetto instructs. “The results letter will include directions on how to request education.”

You can register for your individual education sessions by signing up for the phone call at www.palmettogba.com/event/pgbaevent.nsf/Home.xsp — scroll down to “Home Health Probe and Educate Review Sessions.” Sessions are available from May to July.

Physician participation: “If you would like to invite the certifying referring physician who created the face-to-face documentation to participate in this session, you are welcome to do so as we believe they would benefit from the education session as well,” Palmetto says on the site.

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