Home Health & Hospice Week

Don’t let a Review Choice Demonstration glitch throw off your claims.

The problem: RCD providers “who are under a postpayment review option (Choice 2 or Choice 4) may have had their claims adjusted by a 32I type of bill claim,” RCD contractor Palmetto GBA reports. “When these adjustments occurred, the patient’s status may have been changed to a discharge status when the status on the original claim was anything other than a discharge.”

That’s trouble because as of Jan. 1, “providers are supposed to be submitting a one-time 32A to open an election for a patient and from there would only need to submit final claims. With the 32I adjustments discharging patients, this causes the subsequent claims to return stating that there is no open election for the patient,” Palmetto explains.

The solution: “Please do not submit a new NOA or take any claim action to work around this issue,” Palmetto asks. And Palmetto “has resolved this issue for postpayment adjustments processed by Palmetto GBA from 4/19/22 forward. You may see some activity on your claims as we adjust them to correct patient status.”