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Home Health & Hospice Week

Reimbursement:

Use These 4 Tips To Defend Long-Stay Claims

Published on Tue Jul 28, 2009

Intermediary cracks down on long-stay patients with new probe. Get ready for a higher level of scrutiny for patients you've had on service for years. Regional home health intermediary Cahaba GBA is putting the medical review spotlight on claims for patients with a length of stay greater than 999 days. A new widespread review edit will select these claims and review them for medical necessity, Cahaba says in its July provider newsletter. Cahaba initiated the probe as a result of data analysis, it points out. The topic code for this review will be 5008W. A length of stay of 999 days is almost three years, says consultant Betty Gordon with Simione Consultants in Westboro, Mass. "These patients should be few and far between," not regulars on your roster, she adds. Patients who need such long-term services include those with foley catheters, pernicious anemia that requires B12 injections, and sometimes blind [...]
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