Home Health & Hospice Week

Industry Note:

Watch Out For New Claims Requirement

You'd better be sure your beneficiaries' names and HICN numbers match what's in the Com-mon Working File, or risk slowed cash flow.

Starting Oct. 1, MACs are returning claims that don't have bene names and HICNs that match the CWF, Palmetto GBA cautions on its website. "Providers should assure they report the beneficiary's name and Medicare HICN exactly as they appear on their Medicare card and in CWF," Palmetto advises. "Do not place hyphens or blanks in the HICN field."

Tip: "If the Medicare card and/or CWF displays the beneficiary name with a suffix (e.g. Jr., Sr., II, III, etc.), report the name exactly as shown," Palmetto instructs. "If the claims are filed electronically, providers should ensure the Electronic Data Interchange (EDI) loop for the suffix field is populated and that the suffix is not added to the beneficiary's last name."

Before you call your MAC, "compare the information billed on the claim with the information listed on the beneficiary's Medicare card and in the CWF and resubmit the claim after making the appropriate corrections," if applicable, Palmetto GBA counsels.

The transmittal from April detailing the change is online at www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R2449CP.pdf.

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