Home Health & Hospice Week
Industry Notes:
Don't Forget That You Can Appeal CERT Denials, MAC Reminds Providers
Published on Fri Jun 26, 2015
Don’t take a CERT denial as the last word. Comprehensive Error Rate Testing denials “also have appeal rights and providers may appeal through the normal appeal process with National Government Services,” the HHH Medicare Administrative Contractor explains in an email message to providers. “For the first appeal level (redetermination), providers have 120 days from the date the claim was adjusted in the FISS system to reflect the CERT error.”
Other Articles in this issue of
Home Health & Hospice Week
- Fraud & Abuse:
Feds Use Drug Bust Tactics In Latest Medicare Fraud Strike
Home care providers targeted in latest national takedown. Don’t feel like you are safe from [...] - Strategy:
Take These Steps In Face Of Compliance Scrutiny
Old saying applies: An ounce of prevention is worth a pound of cure. The feds [...] - Enforcement:
Diversify Your Referring Docs Or Face Scrutiny
Miami leads enforcement head count. The latest national health care fraud takedown extended its reach, [...] - Hospice:
Hospice Agrees To $10 Million Settlement After Self-Reporting
Eight-figure repayment due to lack of GIP documentation. You’d better make sure your records supporting [...] - Lawsuits:
Whistleblower Rakes In $200K Cut Of Fraud Settlement
Latest Medicare fraud cases center around marketing. The record-breaking national health care fraud takedown doesn’t [...] - Hospice:
Hospice Facility Openings Continue Nationwide
From 3 to 16 beds, new facilities are serving their communities. GIP care may be [...] - Mergers & Acquisitions:
Market Consolidation Revs Home Care M&A Engine
Affiliations seem to be gaining popularity. Unreliable reimbursement and ever-increasing regulatory scrutiny don’t seem to [...] - Mergers & Acquisitions:
Hospitals Shed Hospice, Home Care Units
Competition squeezes out non-specialists. It’s not all acquisitions and mergers, though. Rough market conditions are [...] - Industry Notes:
Watch Out For This Hospice Denial Error
Take evasive action for this claims system glitch, or wait it out. Hospices will finally [...] - Industry Notes:
Furnishing Patient Care In The Home Saves Medicare Program Money, Demo Shows
An Affordable Care Act demonstration encouraging care at home is doing well. The Independence at [...] - Industry Notes:
Don't Forget That You Can Appeal CERT Denials, MAC Reminds Providers
Don’t take a CERT denial as the last word. Comprehensive Error Rate Testing denials “also [...] - Industry Notes:
Get Your PECOS System Facts Here
CMS is trying to demystify Medicare enrollment and the PECOS system with some new educational [...] - Industry Notes:
Beware: Social Media Exchanges Can Lead You Into A HIPAATrap
Handling PHI over social media can be tricky. While the rules can be confusing, you [...]
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