Home Health & Hospice Week

Hospices wrestling with transfer patient billing problems can use a form to help them resolve the issue, at least at one HHH Medicare Administrative Contractor.

“On occasion, a hospice claim will receive an edit from the Common Working File (CWF) indicating your claim overlaps the dates of service on a claim from another Medicare provider (e.g., hospice, hospital, or skilled nursing facility providers),” MAC CGS notes on its website. “This typically occurs in transfer situations, or when claims are submitted with incorrect dates of service, or a notice of election (NOE) is submitted before a prior hospice submitted their discharge claim,” the MAC explains.

Do this: “CGS encourages hospice providers who submit claims to CGS to work with the Medicare provider that is involved in the overlap situation,” it says. “However, if after three contacts, the hospice is not successful in resolving the overlap dispute, they may complete the ‘Hospice Dispute Request for Assistance’ form to request assistance from CGS.”

Among other items, the form requires the dates of the three contact attempts, along with the contact name and time of the attempt. See the form at www.cgsmedicare.com/hhh/ forms/pdf/hospice_dispute_form.pdf.