Home Health & Hospice Week

Ahead of Pre-Claim Review’s April 1 launch in Florida, the Centers for Medicare & Medicaid Services is reminding all HHAs of face-to-face physician encounter requirements that are necessary for their payment. But the effort might also serve to remind physicians of their F2F duties for their home health patients, agencies hope.

“Physicians or non-physician practitioners are required to have face-to-face encounters with beneficiaries before they certify eligibility for the home health benefit,” CMS says in its weekly MLN Connects newsletter that goes out to all provider types. “One aspect of the certification is for the certifying physician to certify (attest) that the face-to-face encounter occurred and document the date of the encounter.”

Important: “For medical review purposes, Medicare requires documentation in the certifying physician’s medical records and/or the acute/postacute care facility’s medical records to be used as the basis for certification of patient eligibility,” CMS says. “This documentation must include the clinical note or discharge summary for the face-to-face encounter. Avoid home health claims payment denials or improper payment recoveries by understanding Medicare’s requirements.”

CMS offers educational resources including the 2015 HH PPS final rule, Chapter 7 of the Medicare Benefit Policy Manual, and a December 2014 National Provider Call about the requirement at www.cms.gov/Outreach-and-Education/Outreach/NPC/National-Provider-Calls-and-Events-Items/2014-12-16-Home-Health-Benefit.html.