Medicare Administrative Contractor Palmetto GBA is sharing top tips for face-to-face encounter compliance as results from recent Target, Probe and Educate reviews show meeting this requirement is a top struggle.
 
Out of 3,478 claims reviewed, 586 claims were denied from October to December as part of Palmetto's pre-payment review for medical necessity, according to MAC data.
 
Face-to-face encounter requirements caused 27% of the denials. No plan of care or certification came in second with 18% of the denials. Experts note that both of these reasons for denial are often linked to the face-to-face encounter, as requirements around the face to face impact certification.
 
Palmetto has published an article addressing requirements around the face to face and certification. Among the tips: The certifying physician or NPP must document the date of the face-to-face encounter.