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Home Health & Hospice Week

Medical Review:

Beat One Top Denial Reason With 8 Tips

Published on Wed Nov 16, 2011

You should check for ADR'd claims daily. With medical review from government contractors and agencies on the rise, you need to get your ADR basics down pat. You can't get much more basic than responding to an additional development request (ADR). Yet lack of response to an ADR is the number- two denial reason for home health agencies and the number-four denial reason for hospices in Palmetto GBA's third quarter, the HHH Medicare Administrative Contractor reveals in its December provider newsletter. That reflects what reimbursement consultant M. Aaron Little is seeing in the field. "I continue to find agencies with personnel who don't know how to identify that a claim has been selected for medical review," Little tells Eli. Use these tips to combat this common reason for HHA and hospice denials: 1. Monitor for ADRs. You should monitor for ADR'd claims in the Direct Data Entry (DDE) system, Palmetto [...]
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