Home Health & Hospice Week

Industry Notes:

One Medicare Administrative Contractor Offers More Details For Claims Denials

You should get more information about denials that come from one HHH Medicare Admin-istrative Contractor. “Palmetto GBA is now generating Medical Review Claim Review Decision and Education letters to providers that are on provider-specific and service-specific medical review edits,” the MAC says on its website. It started providing the letters last month.

The letters contain “Granular Error Denials along with the Denial Code and Description, Granular Error Education, and References to the Palmetto GBA website for educational information,” the MAC adds.

Plus: Palmetto will also issue a pre-populated Redetermination: 1st Level Appeal form, the MAC says. Providers aren’t required to use the form to appeal, however.

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