Home Health & Hospice Week

You don’t have to pay that therapy invoice if you didn’t know your patient was receiving Part B therapy. In a common scenario, home health agencies receive invoices from physicians or therapists demanding payment for therapy claims that Medicare rejected because Part B therapy is bundled into the home health episode payment.

"Providing services ‘either directly or under arrangement’ [as required in the Medicare Claims Processing Manual] requires knowledge of the services provided during the episode," explains HHH Medicare Administrative Contractor Palmetto GBA in a recently posted question-and-answer set from its July 16 Ask the Contractor Teleconference.

Bottom line: "An HHA would not be responsible for payment to another provider in the situation in which they have no prior knowledge (e.g., they are unaware of physicians orders) of the services provided by that provider during an episode to a patient who is under their home health plan of care," Palmetto reminds HHAs.