Home Health & Hospice Week
MAC Shoots Down 70% Of High-Therapy Claims
Be sure your records for high-therapy claims are up to snuff, because they are under the microscope.
HHH Medicare Administrative Contractor Palmetto GBA reviewed 38 claims with the HIPPS code 5AHK* in the latest quarter, the MAC says on its website. Palmetto partially or fully denied 26 of the reviewed claims — nearly 70 percent.
In some regions, the MAC denied 99 percent of the dollars billed on the claims containing the HIPPS code that represents 20 or more therapy visits.
Face-to-face requirements not met continues to head up the reasons for denials in this edit, Palmetto days. Other top reasons include records not submitted in response to the ADR; the physician’s plan of care or certification being present with a signature, but no date; missing POC or cert; documentation contradicting the OASIS M0 item responses chosen; approved skilled observation now stable; and dependent services denied.
Home Health & Hospice Week
- Face-To-Face:
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HHS Sets The Stage For Medicare Payment Changes
Your outcomes will be more important than ever under new payment emphasis. If you think [...] - Industry Notes:
MAC Shoots Down 70% Of High-Therapy Claims
Be sure your records for high-therapy claims are up to snuff, because they are under [...] - Industry Notes:
Medicare Officials Move Forward With Plans For Home Health Agency 5-Star Rating System
The Centers for Medicare & Medicaid Services is moving ahead with plans to rate home [...] - Industry Notes:
Proportion Of Hospice Chains Providing Medicare Services Shoots Up Over Last Decade
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