Home Health & Hospice Week

A potential huge claims headache has home health agencies scrambling.

The new HH Conditions of Participation that took effect last January require agencies to have information related to a patient’s advanced directives in the Plan of Care, reports the National Association for Home Care & Hospice. If agencies’ PoCs lack this info, the claim can be fully denied.

CERT audits “have uncovered significant noncompliance with this new requirement,” NAHC says. Mass retroactive denials could be on deck.

Do this: Agencies should review their claims and submit corrected claims when this problem is identified. To do that, they need to “secure a signed POC addendum from the certifying physician that includes the required information for the POC,” NAHC advises.

Watch the deadline: “Claim corrections must be filed prior to the close of the one-year window for claim submissions that will begin to close on January 13, 2019,” NAHC warns. “At present, the burdensome [corrections] approach ... is the only option,” the trade group laments.