Home Health & Hospice Week

Palmetto offers additional in-person training.

Don’t expect that Pre-Claim Review “pause” button to stay pressed too long.

HHH Medicare Administrative Contractor Palmetto GBA has issued another PCR educational tool, a 25-minute overview video posted at www.youtube.com/watch?v=drBm2Xuk_ys .

And of course home health agencies in Illinois continue to grapple with the ongoing demonstration program. Palmetto has scheduled two new in-person workshops in the state — one in Chicago on Nov. 9 and one in Springfield on Nov. 10. The three-hour workshops “provide detailed information on the Medicare home health benefit documentation regulations and what documents are needed for a Pre-Claim Review Submittal request, including real examples of affirmed and non-affirmed documentation submissions,” Palmetto says. Information on registering is online at www.palmettogba.com/event/pgbaevent.nsf/SeriesDetails.xsp?EventID=AEMGEK1025.

HHAs served by CGS can listen to a replay of the MAC’s PCR Ask-the Contractor Teleconference, held Sept. 27, at www.cgsmedicare.com/hhh/education/Education.html.

But Illinois agencies aren’t finding MACs’ PCR tools much help, contends Chicago-based regulatory consultant Rebecca Friedman Zuber.

For example: Palmetto recently issued a list of information reviewers expect to find in the physician’s face-to-face clinical note (see Eli’s HCW, Vol. XXV, No. 36). “We are not necessarily finding that just having all these elements gets us where we need to be,” Friedman Zuber says of the list. And there is no regulatory basis for this list anyway, she points out.

Plus: “How can the home health industry ensure that physicians are writing compliant clinical notes?” Friedman Zuber asks. “If we refuse these notes, the patients don’t get care, or we just take on the liability and hope we can get paid, which is what is happening,” she tells Eli.