Prospective Payment System; RECONCILE YOUR PPS CLAIMS OR RISK LOSSES
Published on Tue Jan 13, 2009
Don’t let the confusing PPS refinements trip up your billing. If you don’t keep on top of your PPS payments,your bottom line is likely to suffer. But you need to know the prospective payment system ropes to figure out whether your payments are accurate under the complicated system. The host of PPS errors that intermediaries are making adjustments for now are proof that mistakes occur all the time. And for many errors Medicare requires you to bring the correction to intermediaries’ attention yourself. Because PPS methodology is so confusing under the refinements that took effect Jan. 1, 2008,it’s tempting to let unexplained payment differences slide, especially if the dollar amount isn’t huge. Don’t fall into that trap, warned consultant M. Aaron Little with BKD in Springfield, Mo. in a recent Eli-sponsored audioconference, “Smart Easy Ways to Reconcile Medicare Home Health Billing Adjustments.” “PPS refinements has been very, very complex,”Little told attendees. [...]