Eli's Hospice Insider

Published on Wed Jan 28, 2015 PDF

You’ll have a hard time making your Notice of Termination/Revocation filing deadline if you lag on your hospice claims billing.

“Will a NOTR process if the discharge/revocation occurs during a benefit period that has not yet been established at the CWF?” a hospice asks in a recent question-and-answer about CR 8877.

“No. The NOTR will RTP with a reason code indicating that the revocation/termination date does not match a benefit period posted to the CWF,” the Centers for Medicare & Medicaid Services responds. In order for an NOTR to process, the benefit period in which the patient was discharged has to be established in the CWF.”

For example: “If the beneficiary revokes or is discharged on November 2nd, but the current benefit period posted in the CWF ends on October 27th, the claim for the October billing period must be submitted to get the subsequent benefit period posted to the CWF before an NOTR will process,” CMS explains in the Q&A posted on multiple HHH Medicare Administration Contractor websites.

Resource: More about the NOTR five-day billing deadline is in the CR at www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R3032CP.pdf.