Home Health & Hospice Week
Industry Notes
• Clinical review judgment (CRJ) may help you if your claims get caught up in medical review, but only if you submit the right documentation. What it is: CRJ involves two steps, CMS says in May 14 Transmittal No. 338 (CR 6954) -- "(1) the synthesis of all submitted medical record information ... to create a longitudinal clinical picture of the patient, and (2) the application of this clinical picture to the review criteria to make a reviewer determination on whether the clinical requirements in the relevant policy have been met." What it's not: "Clinical review judgment does not replace poor or inadequate medical record documentation," CMS stresses in related MLN Matters article MM6954. "Nor is it a process that review contractors can use to override, supersede or disregard a policy requirement." The transmittal is online at www.cms.gov/Transmittals/downloads/R338PI.pdf and the MLN Matters article is at www.cms.gov/MLNMattersArticles/downloads/MM6954.pdf.
Home Health & Hospice Week
- Hospice:
Gentiva To Buy Odyssey For Nearly $1 Billion
Don't expect your hospice's valuation to go up as a result, one expert cautions. It's [...] - Mergers & Acquisitions; Home Health Deals Continue To Build
Check out the decade's largest home health transactions. Despite uncertain Medicare reimbursement and other pitfalls, [...] - Audits:
RACs Can No Longer Keep Fees After Losing Appeals
Plus: You'll soon be able to review the most common errors that the RACs find. [...] - Know Your Facts:
Recovery Audit Contractors: Know These RAC Fast Facts
RACs are just another tool in the government's arsenal to collect improper payments. You've got [...] - Education:
Sidestep Compliance Landmines With This Training
Check out Eli audioconferences on the CAHPS requirement, joint ventures, wound healing, HIPAA, QAPI, and [...] - Industry Notes:
Keep Track Of Your Incorrect NRS Payments
New system glitch is overpaying claims. Add one more headache to your Medicare claims pain [...] - Industry Notes
• Home care providers may benefit from a lawsuit filed by physician groups over the [...] - Industry Notes
• One part of the regional home health intermediary-to-Medicare Administrative Contractor (MAC) transition is moving [...] - Industry Notes
• Take time to fill out some user ID-related paperwork if National Government Services is [...] - Industry Notes
• Clinical review judgment (CRJ) may help you if your claims get caught up in [...] - Industry Notes
• Palmetto GBA's April 30 deadline to send in licensure information may be past, but [...] - Industry Notes
• Four new individuals will be helping decide the fate of your Medicare reimbursement. The [...] - Industry Notes
• If you feel like the authorities have turned a deaf ear when you've tried [...] - Industry Notes
• An April fix for the Medicare claims system incorrectly applying U5181 didn't work, reports [...] - Industry Notes
• Baton Rouge, La.-based LHC Group Inc. plans to buy Twin Falls, Idaho-based Idaho Home [...]
