Home Health & Hospice Week

Don’t let Medicare’s own billing system problems continue to cost your hospice.

“Medicare has determined that timely-filed [Notices of Election] with inadvertent errors that cannot be immediately corrected due to Medicare system constraints (and thus returned to the provider for correction, causing late system acceptance of NOEs and non-covered days) are outside the control of the hospice and so qualify for an exception to the timely filing requirement in the circumstances described below,” the Centers for Medicare & Medicaid Services says in a new MLN Matters Article.

“MACs will grant an exception for the late NOE if the hospice is able to provide the MAC with documentation showing: (1) When the original NOE was submitted (2) When the NOE was returned to the hospice for correction or was accepted and available for correction, and (3) When the hospice resubmitted the NOE,” CMS says in Article #SE1633.

Deadline: “MACs will grant the exception if all documentation is provided and the hospice took appropriate actions within 2 business days to make corrections,” CMS continues. “Once the NOE is returned for correction the hospice will have 2 business days to resubmit. When the NOE was posted to the Common Working File (CWF) and must be cancelled and resubmitted, they will have 2 business days to cancel the NOE and then 2 business days to submit the new NOE after the date that the cancellation NOE finalizes.”

You can lighten your workload with some up-front effort. “If the hospice provides sufficient information in the Remarks section of its claim to allow the MAC to research the case, then MACs will make a determination without requesting the additional supporting documentation described above,” CMS adds.

The catch: “All current provider education about errors that can be fixed immediately remain[s] in effect,” CMS says. “MACs will grant an exception only for instances where timely-filed NOEs contained errors that could not be immediately corrected due to system constraints.”

See the article at www.cms.gov/Outreachand-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1633.pdf.