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Home Health & Hospice Week

Industry Notes:

New Claims System Update Brings New Problems

Published on Fri Jan 28, 2011

Watch out for these reimbursement-draining payment glitches. If your claims are getting ugly in the new year, you're not alone. A laundry list of claims glitches has accompanied the Medicare claims system update in 2011, contractors report. For example: "FISS is not recognizing that the units for [hospice continuous care] revenue code 0652, which are represented in 15-minute increments, reflect a full day," regional home health intermediary Cahaba GBA says on its website. Thus claims with that code are incorrectly receiving reason code 31503 and returning to provider. Another problem: "Home Health claims and RAPs that were received on January 3 through January 5 may have processed with incorrect units," HHH MAC NHIC says in a Jan. 25 e-mail to providers. But at least this problem isn't messing up your payment, "since submitted units are not used in the calculation of reimbursement for Home Health claims and RAPs," NHIC explains. [...]
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