Home Health & Hospice Week
Know When To Include Another NPI On Claims
You’ll need to know the NPIs of the facilities in which your patients reside when reporting certain place of service codes on hospice claims, or face payment slow-downs. The problem: Reason code 34952, indicating that a service facility National Provider Identifier is required on the claim but was not reported, “consistently appears in the top Claim Submission Error (CSE) data,” says HHH Medicare Administrative Contractor CGS on its website. “Claims that do not include an NPI in the SERV FAC NPI field when required will be sent to the return to provider (RTP) file (status/location T B9997) with reason code 34952, for you to correct.” The solution: Report the NPI of the facility where the patient received services when billing any of the following POS HCPCS codes: Q5003 (hospice care provided in nursing long term care facility [LTC] or non-skilled nursing facility [NF]); Q5004 (… skilled nursing facility [SNF]); Q5005 (… inpatient hospital); Q5007 (...long term care hospital [LTCH]); or Q5008 (...inpatient psychiatric facility). Exception: “This is not required when the facility is the same as the billing hospice,” CGS notes. Report the service facility NPI in Loop 2310E in the 5010 electronic claim format or the SERV FAC NPI field in the Fiscal Intermediary Standard System (FISS) on Claim Page 03. “Help reduce claims processing time and avoid payment delays by ensuring this information is reported on the claim when required,” CGS urges.
Home Health & Hospice Week
- Conditions of Participation:
Prioritize These 6 Challenges In Your CoP Prep
Will your vendors be as ready as you are? While home health agencies are happy [...] - Regulations:
Beware States Lagging On CoPs
States are dragging their feet on subunits, state licensure changes. You’ve been working steadily on [...] - Fraud & Abuse:
OIG On The Hunt For Fraud Indicators In Your Data
Your own data may single you out for scrutiny. This month shows why you should [...] - Enforcement:
Home Health, Hospice Fraud Remains Front & Center
Fraud takedown highlights Medicare fraud. Convincing lawmakers you need a break might be even more [...] - Industry Note:
Live Discharge Rate Linked To Profitability, Study Finds
What does your live discharge rate suggest about your hospice? A new study adds fuel [...] - Industry Note:
MAC Denies 9% Of High-Resource Claims In One Review
Therapy once again tops the reasons for denials in Palmetto GBA’s latest medical review effort. [...] - Industry Note:
OIG Educates Providers On How To Report Fraud — Anonymously
Whistleblower lawsuits are costing home care providers big. But disgruntled employees don’t have to resort [...] - Industry Note:
Know When To Include Another NPI On Claims
You’ll need to know the NPIs of the facilities in which your patients reside when [...] - Industry Note:
HH Nearly Only Sector With Spending Decrease
While policy- and lawmakers seem to be furiously throwing up roadblocks to home health growth [...] - Industry Note:
Keep Tabs On Your Revalidation Deadline
You may want to check CMS’s revalidation schedule to see if your date is coming up [...] - Industry Note:
New PEPPER Data Out
Get your latest free benchmarking stats from Medicare. A new release of the Home Health [...] - Industry Note:
HealthSouth Changes Name
HealthSouth Corp. will change its name to Encompass Health Corp., effective in January, the Birmingham, [...] - Industry Note:
Free HIPPA BA Tool
If one of your business associates commits a HIPPA breach with your patients’ data, you [...] - Industry Note:
Medicaid HH Funding Still In Peril
The Senate’s version of an Obamacare repeal-and-replace bill has failed to pass the Senate, but [...]
