Home Health & Hospice Week

Would your face-to-face documentation pass medical review muster?

Have you been letting docs slide on face-to-face documentation because it hasn’t been affecting claims? If so, you may come to regret it.

The Comprehensive Error Rate Testing program is shooting down home health agency claims with F2F problems, reports HHH Medicare Admini-strative Contractor Palmetto GBA.

Problem: "Palmetto GBA has seen an in-crease in the number of home health claims which have been chosen for Comprehensive Error Rate Testing (CERT) review, that are being denied as not meeting the home health face-to-face encounter documentation requirements," the MAC says on its website. "When providers are responding to the CERT contractor’s request for medical records, they are providing insufficient information, specifically in relation to the requirement to have a ‘brief narrative which describes how the clinical findings of the encounter support the patient’s homebound status and need for skilled services.’"

Solution: "The most common error with the documentation is submitting the diagnosis without any accompanying documentation about the specific limitation(s) that render the beneficiary homebound," Palmetto explains. "Providers are advised to assure their home health face-to-face encounter documentation includes this required information in order to prevent future claim denials."

But it isn’t always easy to achieve proficient homebound documentation, since such F2F documentation relies on the physician, HHAs say.