An issue involving National Provider Identifiers (NPIs) has caused home health agencies and hospices nationwide to have problems submitting claims.
 
Medicare Administrative Contractors (MACs) CGS, NGS and Palmetto say they are aware of the issue.
 
NPIs are “falling off the crosswalk, which is causing home health billing requests for anticipated payment (RAPs) and claims and hospice Notices of Election (NOEs) and claims to go to the provider’s Return to Provider (RTP) file,” CGS says in a release. “Please note that the Fiscal Intermediary Standard System (FISS) is unable to assign a PTAN, therefore, providers are unable to see the RAPs, NOEs and claims affected by this issue in their RTP file.”
 
The scope of the issue nationally isn’t immediately clear, nor is a timeframe for how quickly it might be resolved. However, some providers say NGS told them the issue would take seven to 10 business days to resolve, Katie Wehri, hospice operations expert for the National Association for Home Care & Hospice (NAHC), told HHL Oct. 6. Palmetto says that the issue affects "a very limited number of providers" and does not list a timeframe for the issue to be resolved, Wehri adds.
 
Also as a result of the issue, in some instances rejections are occurring when a provider or billing vendor is attempting to submit a batch of claims, CGS says.
 
Ultimately, hospices should be paid as though the NOEs were filed timely.
 
In Change Request 8877/Transmittal 3032, CMS noted that hospices may request an exception to timely filing of NOEs. The process is outlined in the transmittal. If the exception is approved, CMS would waive the consequences of failing to file a complete and timely NOE.
 
Among those exceptions: An event causing a data filing problem due to a CMS or MAC systems issue beyond the hospice’s control.
 
In its Oct. 5 post, CGS noted that exception requests for the latest issue will be granted if hospices submit the necessary documentation.
 
Related link: View MLN Matters article about Change Request 8877/Transmittal 3032 at http://go.cms.gov/1jbjGzj.