Home Health & Hospice Week

Pre-Claim Review:

Know The Certifying Physician's OASIS Responsibilities

Refer to latest Frequently Asked Questions for Pre-Claim Review answers.

Question: Under the Pre-Claim Review program, is the certifying physician now required to sign the OASIS document?

Answer: It depends, the Centers for Medicare & Medicaid Services says in a recently updated Frequently Asked Question set on PCR. “The certifying physician does not need to sign an OASIS if it is being used to determine medical necessity,” CMS confirms in FAQ #63. “However, if the OASIS is being incorporated into the physician record to show eligibility, it would need to be signed by the physician.”

Note: See the FAQs, including items on physicians’ resistance to face-to-face and other home health documentation requirements, at www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/Pre-Claim-Review-Initiatives/Downloads/Pre-Claim-Review-Frequently-Asked-Questions-11_17_16.pdf.

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