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Home Health & Hospice Week

Industry Note:

Remember Appeals For Incorrect F2F Doc-Related Denials

Published on Fri Jan 20, 2012

Don't forget to file for reopenings when your HHH MAC erroneously denied your claim for face-to-face reasons. CMS clarified last month that it's OK for a different physician to conduct the F2F encounter and sign the plan of care, and that HHAs  aren't required to document a hand-off between those physicians (see Eli's HCW, Vol. XX, No. 44-45, p. 352). Now HHH MAC NGS is facilitating those reopenings by furnishing a fax number and other submission instructions. (E-mail editor Rebecca Johnson at rebeccaj@eliresearch.com for a free link to and copy of the instructions.) But don't count on that cash quite yet. "A determination that face-to-face requirements have been met will not result in automatic payment of the claim," NGS cautions on its website. "A complete and full review to determine if payment should be made will be necessary." Appeals: If you've already filed a redetermination (appeal) request and the [...]
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