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Home Health & Hospice Week

Industry Note:

Transfer Denials May Rise

Published on Wed Sep 28, 2011

Checking the Common Working File for a patient's Medicare history is more important than ever under a new clarification from HHH MAC CGS. CMS issued a transmittal in May requiring HHAs to furnish transfer notifications to any patient who's had a home health episode within the 60 days prior to the current agency's start of care date, CGS explains on its website. Therefore, "CGS will now review the beneficiary's episode history when making this determination" of which agency is the primary one in a disputed transfer, the MAC explains. "If a beneficiary was receiving home health services from another HHA within 60 days of the second HHA's episode start date, CGS will review the patient status code submitted on the first HHA's episode when there is a dispute as to which HHA is the primary agency. If the patient status code indicates that the beneficiary was still a patient of [...]
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