Home Health & Hospice Week
Hospice Pay Reform Correction Headache Continues
Check your 'adjusted' claims. If you submitted adjustments to your Routine Home Care hospice claims that were paid incorrectly due to payment reform in 2016, don't assume your trial is over. The problem: Some hospice claims "should have received a corrected payment, but did not due to incorrect line item date(s) of service billed for RHC revenue code 0651," HHH Medicare Administrative Contractor CGS says on its website. "For example, a claim is submitted with an admission date of April 26, 2017, with the dates of service 060117 - 063017 showing 30 units, representing 30 days. However, the claim reported the first date for the RHC level of care as 062517 instead of 060117. As a result, the Fiscal Intermediary Standard System (FISS) determined the dates from 0625 to 0630 occurred during the first 60 days of the episode and were paid the incorrect RHC amount." The solution: You'll need to correct the line item dates of service if they are in error. "Hospice claims are required to report separate line items for the level of care each time the level of care changes. This includes revenue codes 0651, 0655 and 0656," CGS explains. "If you have a claim that you feel paid the incorrect RHC 'High' or 'Low' rate, please review to ensure the correct line item dates of service was reported, and adjust accordingly," the MAC urges. See more details about the fix at www.cgsmedicare.com/hhh/pubs/news/2017/1217/cope5643.html.
Home Health & Hospice Week
- Medical Review:
Unravel TPE Mysteries With MACs' Help
Getting ADRs without a TPE letter? Better check on it. Although the Targeted Probe & [...] - Reimbursement:
MAC Hits These Hot Spots For TPE
Make sure you're prepared to defend claims for long-stay hypertension patients. The data crunching the [...] - Budget:
MedPAC Readies Cut Recommendations
Advisory commission pulls no punches with proposed 5 percent cut for home health agencies. At [...] - Therapy:
Get Therapy Out Of The HH PPS Calculation, MedPAC To Urge
Copays also eyed once again. While most home health agencies cheered when CMS pulled back [...] - Prospective Payment System:
Post-Acute Payment PPS Still On MedPAC's Mind
Commission looks for ways to decrease payments to for-profits, freestandings. It may not be on [...] - Hospice:
Creeping Hospice Stats Lend To Rate Freeze Argument
Profit margin is back up. The weather won't be the only thing freezing, if an [...] - HIPAA:
Claims Audits Aren't The Only Ones That Matter
Don't overlook IT audits. You're familiar with Medicare audits and maybe even HIPAA audits - [...] - Industry Note:
Hospice Pay Reform Correction Headache Continues
Check your 'adjusted' claims. If you submitted adjustments to your Routine Home Care hospice claims [...] - Industry Note:
Medicare Enrollment Application Fee Rises This Year
The fee for submitting your Medicare enrollment application, including for revalidations, has gone up. The [...] - Industry Note:
Dial In To Find Out More About Medicare's New Low Volume Appeals Option
If you have fewer than 500 Medicare appeals pending, you may want to listen in [...] - Industry Note:
Shareholder Protests Proposed Deal For Humana To Acquire Kindred At Home
Kindred Healthcare has agreed for its Kindred at Home division to be acquired by Humana [...] - Industry Note:
Ohio Health System, Home Care Provider Form Joint Venture
Summa Health system in Ohio is forming a joint venture with its Summa Health at [...]
