Agencies continue to get tripped up on documentation requirements in pre-payment reviews.
We’re looking for national benchmark for days from discharge to final claim. We also want to know if there is a benchmark or tolerance level for unsigned orders over 14 days?
Responses to “How often patients got better at taking their drugs correctly by mouth” have improved, according to the latest data from CMS’ Care Compare, published in January.
With one year into OASIS-E, the new Transfer of Health (TOH) process measure scores are trending upward.
by: DecisionHealth Staff
Terminal diagnosis tops list of denials for new hospices One of the most frequent denial reason for new hospices under pre-payment review is “Documenation submitted doesn’t support prognosis of six months or less.” That’s according to the Palmetto GBA’s medical review results from July to September 2023. They looked at 52 hospice providers from six states: Florida, Georgia, Indiana, New Mexico, Ohio and South Carolina.
Nearly 15% of Medicare beneficiaries ages 65 to 74 reported being food insecure in CMS’ most recent Financial Well-Being Report for 2021. The report included beneficiaries living in the community.
COVID-19 continues to impact patient breathing in some patients, but agencies nationally are seeing improvement in the measure “How often patients’ breathing improved,” according to Care Compare results.
Agencies increased salaries over the last year to attract and keep quality clinicians.
Home health agencies are expecting more of their revenue to come from Medicare Advantage (MA) plans this year as enrollment grows
and payment rates decline for traditional Medicare fee-for-service.
More than half of recent medical review denials from MAC Palmetto GBA were due to face-to-face encounter deficiencies.


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