Home Health & Hospice Week
Toe The Sequential Billing Line, MAC Warns
Failing to follow sequential billing rules for hospice is not only cash flow-draining, it’s also a threat to your compliance status. So says HHH Medicare Administrative Contractor CGS in a recent post to its website. “As a Medicare provider, you are responsible to ensure compliance with Medicare regulations; therefore, this article serves as a reminder of the sequential billing requirement,” CGS says. “Reason code 37402 is consistently the top claim submission error (CSE) for hospice providers,” the MAC says. “From January through August 2017, CSE data shows an average of 2,437 claims per month received the out of sequence error.” You may know you have to bill hospice claims in sequence. But did you realize you have to correct them that way also? “If the January claim is in RTP because of an invalid HCPC code, and the February claim was submitted, the February claim will go to RTP because no prior claim was found,” CGS explains. “You must first correct the January claim out of RTP. Once the January claim is corrected and moves to a suspended status/location, the February claim can be F9ed out of RTP.” More tips: Hospice claims must conform to calendar months; be consecutive with no gaps; and be billed monthly, CGS says. More information on hospice sequential billing is at www.cgsmedicare.com/hhh/pubs/news/2017/0917/cope4540.html.
Home Health & Hospice Week
- Prospective Payment System:
Proposed HHGM Changes Stir Up Therapists
CMS expects agencies providing more therapy visits to see bigger pay cuts under pay reform. [...] - Payment:
HHGM Bell Tolls For Therapy-Intensive HHAs
It’s not just your imagination — Medicare is out to cut therapy reimbursement with the [...] - Therapy:
The Gaming Will Go On
Eliminating therapy from case mix won’t fix what ails it, commenters say. The Centers for [...] - Reimbursement:
$1 Billion Payment Cut Will Not Improve Home Health Care
Get your act together on case mix, commenters tell CMS. To eliminate therapy as a [...] - PPS:
Payment Reform Must Be Budget-Neutral
One of the most important tenets of a viable payment reform model is that it [...] - OASIS:
OASIS Edit Will Return — Not Deny — Claims, For Now
Take 3 steps to resolve 37253 problems. The OASIS edit that took effect in April [...] - Industry Note:
CMS Slows Implementation Of Cross-Setting Measures
These IMPACT Act elements shouldn’t impact you in 2018. You’ll have one less thing to [...] - Industry Note:
HHGM Bill Disappoints
A new bill to delay the Home Health Groupings Model may not be all home [...] - Industry Note:
Toe The Sequential Billing Line, MAC Warns
Failing to follow sequential billing rules for hospice is not only cash flow-draining, it’s also [...] - Industry Note:
Mass. Agency Owner Arrested For Fraud
The owner of Worcester, Massachusettsbased Lifestream Healthcare Alliance has been arrested on Medicaid fraud charges [...] - Industry Note:
Don't Include Patient Names On Hospice Adjustment List
If you want to take advantage of easier hospice billing corrections for Routine Home Care [...] - Industry Note:
Hospital Closes Agency
Another hospital-based home health agency has closed. Wallowa Memorial Hospital in Enterprise, Oregon, shuttered its [...] - Industry Note:
Hurricane Scams A Threat
Con artists always know to strike when the irons are hot. And in the midst [...]
