Home Health Line
04/28/2014
Remind clinicians that the resumption of care (ROC) and transfer assessments must be completed within two days after they find out about a qualifying stay in an inpatient facility in order to get paid by CMS. 
 
04/28/2014
HME providers have been blessed by a recent reversal of denials by C2C Solutions, the qualified independent contractor (QIC) that processes appeals. But there’s no sign that home health agencies will see any movement in their two-and-a-half-year backlog of appeals.
 
04/28/2014
Asking one simple question, “How can we help you?” can protect your agency against liability in the event that an employee files a disability discrimination lawsuit. 
 
04/28/2014
Don’t assume that your provider enrollment, chain and ownership (PECOS)-related troubles are over. Agencies are facing a new wave of denials caused by missing hospitalist information.
04/28/2014
CMS is giving agencies another chance to appeal overpayments for patients who were not lawfully present in the U.S. at the time the claim was submitted. 
 
04/28/2014
Agencies that bill to Palmetto GBA can expect even more scrutiny of high-therapy claims with two HIPPS codes, 5CHK* and 5BHK*, as the Medicare administrative contractor (MAC) initiates a targeted review of these claims.
 
04/28/2014
The national averages for the multifactor falls risk assessment conducted increased by one percentage point to 98%, according to the most recent update of Home Health Compare, released April 17.
 
04/28/2014
The final version of the Hospice Item Set (HIS) was recently approved — without changes — by the Office of Management and Budget (OMB).
 
04/28/2014
Data from Medicare administrative contractor (MAC) Palmetto GBA recently posted on its website show its top denial reason in 2013 — by a landslide — was face-to-face encounter requirements not met. The MAC, which represents 16 mostly southern states, denied more than $4.6 million last year due to face-to-face rules not met. 
 
04/21/2014
Expect more scrutiny of face-to-face documentation as supplemental medical review contractor (SMRC) StrategicHealthSolutions LLC will look at approximately five claims from every agency nationwide in an effort to create more consistent audits among CMS contractors.
 
 

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