Home Health & Hospice Week
Stay On Track For 5010 Usage
MAC frowns on using 4010 form. CMS may have delayed 5010 enforcement until July 1, but you'd be wise to adopt the new HIPAA-compliant claim format as quickly as possible. "Submitters may continue to submit claims in Version 4010" until July 1, allows HHH Medicare Administrative Contractor Palmetto GBA. But "this is highly discouraged by your MAC," Palmetto stresses on its website. "We will do everything possible to assist you in becoming 5010 compliant." "It's important that all HIPAA-covered entities continue to take the necessary steps to complete the upgrade to Version 5010 as soon as possible," the Centers for Medicare & Medicaid Services urges in a message to providers. Providers may be behind on the 5010 conversion because they have experienced processing difficulties, CMS admits. "Much progress has been made in the successful receipt and processing of claims in the Version 5010 format, [but] CMS is aware that there are still challenges and issues impeding an industry-wide upgrade," the agency says in a separate message to providers. For example: Providers who haven't re-ceived an appropriate EDI authorization to use 5010 can't submit the new claim format, the agency says in a new factsheet troubleshooting 5010 processing problems. A link to the factsheet, "Important Update Regarding Version 5010/D.0 Implementation," is at www.cms.gov/Regulations-and-Guidance/HIPAA-AdministrativeSimplification/Versions5010andD0/. Tip: "To avoid potential cash flow disruptions, providers should consider establishing or increasing a line of credit," CMS says in a factsheet about the transition. "By doing so, they can prepare for possible delays and denials in payer claims reimbursements if noncompliant Version 5010 transactions are submitted." The factsheet, which includes other tips, is at www.cms.gov/Medicare/Coding/ ICD10/Downloads/SmoothTransition.pdf. CMS will hold a national provider call about 5010, including "outstanding fixes impacting the Part A and Part B Version 5010 transition," on April 25. You can register for the call at www.eventsvc.com/blhtechnologies.
Home Health & Hospice Week
- Hospice:
Hospice Payment Reform Rolls Toward 2013 Date
Quality reporting, surveys, and more discussed by CMS reps at industry meeting. Congress has asked [...] - Quality:
Take A Look At Your Potential New Quality Measures For Hospice
Pain, dyspnea, and patient preferences figure in possible future quality measures. Want an idea of [...] - Medical Review:
Shore Up Your Terminal Illness Documentation, Coding
Expect scrutiny for claims with dementia as the primary diagnosis. Denials for terminal illness-related problems [...] - Therapy:
Expect More Medical Review Of Your High-Price Therapy
Heed therapy cap law's new provisions. Therapy cap exceptions now apply through Dec. 31, thanks [...] - Diagnosis Coding:
CMS Settles On One-Year Delay For ICD-10
Don't count on the delay quite yet, coding expert warns. Home care providers have been [...] - Industry Note:
Stay On Track For 5010 Usage
MAC frowns on using 4010 form. CMS may have delayed 5010 enforcement until July 1, [...] - Industry Note:
Study Compares Post-Acute Costs
Home care is the cheapest care setting for post-acute care, and now the industry has [...] - Industry Note:
Home Care Providers See High Nurse Vacancy Rates
Despite the sluggish economy, many home care providers continue to have problems finding nurses. In [...] - Industry Note:
Medicare Contractors Look To RACs For Targets
Recovery Audit Contractors have announced their first home health topics (see Eli's HCW, Vol. XXI, [...] - Industry Note:
Obey Revalidation Date
If you got an extension on your Medicare enrollment revalidation deadline, don't assume it will [...] - Industry Note:
CMS Names More ACOs
The Accountable Care Organization payment model is growing, so you may not want to wait [...] - Industry Note:
Follow These Billing Tips For Hospice Room & Board
When submitting hospice room and board charges to secure a denial, make sure you're putting [...] - Industry Note:
Federal Court Shoots Down Challenge To Extrapolation
Gentiva Health Services Inc.' challenge to an extrapolation case has been shot down in federal [...] - Industry Note:
Multi-State Chain Makes Utah HHA Buy
Cornerstone Healthcare Inc. has bought Zion's Way Home Health and Hospice in St. George, Utah [...] - Industry Note:
HHA Owners Plead Guilty
Two Miami HHA owners and two em-ployees have pled guilty to a $20 million Medicare [...]
