Home Health & Hospice Week
Industry Notes:
Be Sure Your Doc's NPI Info Matches PECOS, Or Risk Your Reimbursement
Published on Fri Feb 27, 2015
If you’re having trouble with PECOS edit-related claims denials, one MAC is offering a helping hand.
“Billing transactions and adjustments for home health services will deny if the attending and certifying physician National Provider Identifier (NPI) and name do not exactly match the NPI and the name that is on the Provider Enrollment, Chain and Ownership System (PECOS) file,” warns Medicare Administrative Contractor CGS in a message to home care providers.
Tool: Use CGS’s new tool to assist in submitting clean claims and to help with denials that do occur. The resource is at http://cgsmedicare.com/hhh/education/materials/pdf/ord_ref_phys_check list_hha.pdf.
Other Articles in this issue of
Home Health & Hospice Week
- Hospice:
Feds Focus Enforcement Resources On Hospices
Whistleblowers rake in nearly $700K in one fraud settlement. Hospices’ efforts to stay off the [...] - Kickbacks:
Fraud-Fighters Turn Attention To Physicians Involved In Home Care Scams
Beware: The feds may be examining your employee roster. The feds continue to demonstrate their [...] - Fraud & Abuse:
Miami Fraudsters Head Up Home Health Hit List
Patient recruiters feature prominently in busted fraud schemes. Miami is holding up its reputation as [...] - Marketing:
Help Your Docs Claim CCM Reimbursement For Your Patients With These 9 Musts
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If you’re wondering which of the practitioners in your referring physicians’ practices can provide chronic [...] - Industry Notes:
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Hospices Wait On Cap Info
If you haven’t submitted your aggregate hospice cap calculation yet, you’re following at least one [...] - Industry Notes:
Congressional Hearing
Don’t count on another ICD-10 delay to save your bacon this fall. On Feb. 11, [...] - Industry Notes:
New Edits Aim To Prevent LUPA Overpayments
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Iowa Agency Pays $5.6 Million To Settle Face-To-Face, Physician Order Charges
Your problems with the face-to-face physician encounter requirements could get you in more trouble than [...] - Industry Notes:
Be Sure Your Doc's NPI Info Matches PECOS, Or Risk Your Reimbursement
If you’re having trouble with PECOS edit-related claims denials, one MAC is offering a helping [...] - Industry Notes:
Small Providers Can't Skip HIPAA Risk Analysis
Don’t expect to get off the hook for HIPAA compliance just because you aren’t a [...]
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