Home Health & Hospice Week

In addition to legitimately related problems, the Pre-Claim Review demonstration is also generating billing glitches.

The problem: Home health claims with a “From date” prior to Aug. 3, but that span Aug. 3, are incorrectly Returning to Provider with reason code C5467 advising a Unique Tracking Number is needed on the claim, HHH Medicare Administrative Contractor Palmetto GBA explains on its website.

“Claims are RTPing that cannot be corrected by the provider because no UTN is required on the claim.”

The solution: “Claims are now being suspended in status and location SMPROA,” Palmetto says. “Providers can now PF9 the affected RTP’d claims so they can suspend for manual processing.”