Palmetto GBA, a Medicare administrative contractor working with agencies in 16 states, has released an updated list of the top denial reasons under home health medical review.
The data is for reviews from January to March 2022.
At the top of the list: nearly half of all denied claims, 45.8%, were due to the provider failing to respond timely to the request for additional medical documentation.
A quarter of denials, 25.8%, were due to face-to-face encounter requirements not being met. An additional 11.9% of denied claims were denied because of no plan of care or certification. And 6% of denied claims were rejected because information provided did not support a particular service or therapy services.