Home Health & Hospice Week
Submit ADR Responses Within 45 Days
Thirty days hath September, but you’ll have 45 to get your documentation supporting an ADR’d claim in to your Medicare contractor. You have 45 days to respond to an Additional Doc-umentation Request (ADR), CMS says in MLN Matters article MM8583, issued on Nov. 14 and effective on April 1, 2015. On the 46th day after the MAC requests the documentation, your claim will be denied if you haven’t sent the requested materials, CMS spells out.
Unfortunately, if you’re in a bind and unable to meet the 45-day threshold, CMS does not appear likely to give you more time. “The reviewer should not grant extensions to providers who need more time to comply with the request,” CMS says in Transmittal 554, also issued Nov. 14. “Reviewers shall deny claims for which the requested documentation was not received by day 46.”
Home Health & Hospice Week
- Fraud & Abuse:
CMS Devises New Ways To Yank Your Medicare Billing Privileges
Providers may live in fear of arbitrary decision-making by CMS. Take extra care with your [...] - Compliance:
Will Your Billing Record Pass Muster On These 6 Factors?
New providers will be at a disadvantage. Medicare will use these six factors to decide [...] - Regulations:
CMS Will Use New Fingerprint Background Checks Under Anti-Fraud Rule
Plus: Your prior Medicare debt history will count against you. In addition to the revocation [...] - Fraud & Abuse:
Guilty Pleas Continue To Pour In From Nation's Hot Spots
Plus, VNSNY faces Medicaid fraud scandal. The feds are racking up guilty pleas and lengthy [...] - Enforcement:
RN Manager Receives Nearly $4 Million In Whistleblower Case
Feds keep the heat on home care providers in recent weeks. A whistleblower in the [...] - Industry Notes:
Avoid Hospice Claims Delays With MAC's Drug Reporting Tips
Medication reporting errors mess up hospice claims processing. Starting back in April, Medicare has re-quired [...] - Industry Notes:
Submit ADR Responses Within 45 Days
Thirty days hath September, but you’ll have 45 to get your documentation supporting an ADR’d [...] - Industry Notes:
Get New Therapy Reassessment Start Date Right
Don’t adjust your therapy reassessment dates for episodes ending Jan. 1 or later, CMS warned [...] - Industry Notes:
CMS Pushes COP Deadline
If you don’t submit your comments on revisions to the Home Health Conditions of Partici-pation [...] - Industry Notes:
Hospitals Shed HHAs
A sign of tough times for home care is two Texas hospitals that are closing [...] - Industry Notes:
NQF Mulls New HHA Quality Measure For Endorsement
Of the 202 quality measures the Na-tional Quality Forum is reviewing for endorsement this year, [...] - Industry Notes:
Rehab Facility Chain Buys 5th Largest HH Company
Inpatient rehab facility chain Health-South Corp. has agreed to buy the parent of Encompass Home [...] - Industry Notes:
HHA Owner Pleads Guilty
A home health agency owner in Texas has pled guilty to stealing patient info from [...] - Reader Question:
What's Wrong With Mailing Postcards To Patients?
Tip: Shell out the bucks for envelopes. Question: We would like to send out postcards [...]
