Home Health & Hospice Week
Industry Notes:
Beware Adjustments To Outlier Claims
Published on Wed Apr 06, 2011
If you need to submit an adjustment for a claim that includes an outlier payment, don't count on holding onto those outlier funds. "It is appropriate for no outlier payments to be made on adjustments when the home health agency is beyond their annual 10 percent outlier limitation for the calendar year at the time the adjustments are initiated," regional home health intermediary Cahaba GBA says on its website. "This is true even if the HHA was below this limitation when the original claim processed creating the initial outlier payment."
Other Articles in this issue of
Home Health & Hospice Week
- Hospice:
Hospices To See 2.3% Pay Bump Starting This Fall
But BNAF wage index reduction takes $80 million out of hospices' pockets. Hospices should see [...] - Compliance:
2 Steps Help Ward Off Payment Suspensions For 'Credible' Fraud Allegations
Home in on these 3 sources of fraud complaints. Beware a new Affordable Care Act [...] - Regulations:
Will Hospice Face-To-Face Change Ease Your Burden?
CMS proposes loosening up who can make the F2F visit for hospice patients. Your hospice [...] - Audits:
Don't Cross The Line When Teaching Staff How To Respond To Auditors, Surveyors
Beware ever saying this. Solid bet: "With all the different entities out there doing audits, [...] - Industry Notes:
F2F Requirement Under Fire In Mainstream Press
New senate letter circulates on the face-to-face requirement. The public is taking notice of the [...] - Industry Notes:
OIG Scrutinizes Consolidated Billing
Don't be surprised if you start getting old bills from durable medical equipment suppliers who [...] - Industry Notes:
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The Wound, Ostomy and Continence Nurses Society has published a position paper that includes helpful [...] - Industry Notes:
Take These Steps When A Patient Won't Sign An HHABN
What do you do when a patient won't sign a home health advance beneficiary notice? [...] - Industry Notes:
Beware Adjustments To Outlier Claims
If you need to submit an adjustment for a claim that includes an outlier payment, [...] - Industry Notes:
Catch Up On Your Cahaba-To-CIGNA Duties
The transition from Cahaba GBA to HHH MAC CIGNA is ramping up. HHAs and hospices [...] - Industry Notes:
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If your non-cancer length of stay rates for hospice patients vary widely from the norm, [...] - Industry Notes:
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Amedisys Inc. saw its earnings drop in the latest quarter. The Baton Rouge, La.-based national [...] - Industry Notes:
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Two Salt Lake City home care providers have become one. Community Nursing Services, a not-for-profit [...] - Industry Notes:
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Get to know a new field in your FISS screen. As of April, "FISS Claim [...] - Reader Question:
What Counts As 'Close To' For Therapy Reevals?
Don't dupe yourself into providing unnecessary non-billable therapy visits. Reader Question: The Centers for Medicare [...]
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