Home Health & Hospice Week

Industry Note:

New CMS Education Takes Aim At Docs Withholding Documentation

Having trouble getting your referring physicians to cough up medical documentation requested by Medicare contractors for your patients? Then they're putting their own Medicare billing privileges on the line.

Ordering and referring physicians have a responsibility to furnish documentation when asked by Medicare contractors, Zone 5 Zone Program Integrity Contractor (ZPIC) AdvanceMed Corp. says in an article newly posted to Palmetto GBA and CGS's websites. A referring/ordering physician's failure to provide the required documentation could result in that physician's Medicare number being revoked, AdvanceMed threatens. The article goes on to list the various regulatory provisions requiring the physicians to furnish documentation.

If the physician asks you to pay for documentation or refuses to provide it altogether, report the doc to the HHS Office of Inspector General for fraud or abuse, the ZPIC urges. The article is on CGS's website at www.cgsmedicare.com/hhh/pubs/news/2012/0112/WR453.pdf.

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