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Home Health & Hospice Week

Industry Notes:

Don't Expect Your PEP Payments Quite Yet

Published on Fri Jan 15, 2010

Also, expect longer wait for outpatient therapy claim payments. The January Medicare claims system update has fixed a number of home health claims problems that were outstanding, regional home health intermediaries report. Claims affected by some of the problems are now processing automatically while providers will need to act on others, RHHI Cahaba GBA notes on its Web site. For example: Previously, some claims that were recoded due to having 20 or more therapy visits were having their HIPPS code removed from the claim. Claims affected by that error that are in the return to provider (RTP) file can now be processed by pressing F9, the intermediary instructs. Not everything is resolved quite yet, though. The system was paying partial episode payment (PEP) adjustment claims incorrectly, sometimes up to hundreds of dollars less per claim (see Eli's HCW, Vol. XVIII, No. 40, p. 311). The January fix has gotten the [...]
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