Home Health & Hospice Week
Resubmitting PECOS Edit- Booted Claims Won't Work
Hold your horses if you are trying to correct a PECOS-edit related error. HHH Medicare Administrative Contractor CGS “has recently seen an increase in providers submitting Reopening requests for ordering/referring denials when the claim is still in a suspended status/location,” the MAC reports in a message to providers. “If the claim is in a suspended status/location (S MXXX), the reopening adjustment will be sent to the return to provider (RTP) file,” CGS explains.
Do this: “A claim with reason codes 37236 and 37237 must be in a finalized status/location D B9997 before submitting a reopening request,” CGS instructs. “Once a claim is denied (status/location D B9997) with reason code 37236 or 37237, a Reopening request may be submitted.”
See more information about reopenings at www.cgsmedicare.com/hhh/appeals/Reopenings.html.
Home Health & Hospice Week
- Face-To-Face:
Agencies Give CMS An Earful On F2F Burdens
Burdensome face-to-face requirement is keeping patients from entering home care. The feds got at least [...] - Compliance:
Face-To-Face Costs Are Crippling Home Health Agencies
Rule commenters note added FTEs to deal with the F2F burden. The face-to-face physician encounter [...] - Regulations:
HHAs Skewer Proposal To Base Eligibility Determination On Docs' Clinical Records
Can agencies obtain F2F relief instead of just a burden swap? If CMS thinks it [...] - Prospective Payment System:
One Agency's Letter Encapsulates F2F Struggles
Agencies are between a rock and a hard spot, and that rock is poised to [...] - Human Resources:
Take These 3 Steps To Keep Your Employees Engaged
Follow this expert advice to create a ‘get it done’ culture in your agency. Think [...] - Industry Notes:
Do You Know Your NPI From Your PTAN?
CMS offers tips on these basics. You know just where to list your NPI on [...] - Industry Notes:
Resubmitting PECOS Edit- Booted Claims Won't Work
Hold your horses if you are trying to correct a PECOS-edit related error. HHH Medicare [...] - Industry Notes:
AHATakes On HHS Over Claims Extrapolation
Extrapolation of claims errors may not bedevil home care providers as much under prospective payment [...] - Industry Notes:
Transfer Hospice Patients Get Double HIS
Transfer patients get a double helping of data under the new Hospice Item Set system. [...] - Industry Notes:
Tune In For Free PEPPER Report Training
Confused about how to use your hospice PEPPER report? PEPPER contractor TMF Health Quality Institute [...] - Industry Notes:
MAC Offers Job Aid For Timely Claims Filing
Don’t think a claim adjustment will get you out of Medicare’s one-year timely filing deadline. [...] - Industry Notes:
Bankrupt Hospice Pays Nearly $3M To Settle Charges
A big chunk of San Diego Hospice’s remaining assets are going to its former employees [...] - Hospice:
Focus On These Cancer Patients To Facilitate Hospice Access
New study points the way to underserved populations. If you don’t see a lot of [...]
