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Beware Returned Claims When Meeting NOE Filing Deadline

Published on Thu Jul 23, 2015 Print Friendly and PDF PDF

Get answers to your burning NOE filing questions from one MAC.

One MAC is offering a helping hand when it comes to billing hospice NOEs on time.

Background: In the 2015 final hospice payment rule, the Centers for Medicare & Medicaid Services put a five-day submission deadline in place for Notices of Election and Termination. The NOEs must be submitted and accepted by the MAC within five days of the effective date of election or Medicare won’t cover the days until an NOE is filed (see Eli’s Hospice Insider, Vol. 7, No. 10).

CGS’s Provider Contact Center “continues to receive questions about these billing requirements,” the MAC says on its website.

For example: “If an NOE is submitted timely (within 5 days after admission), but is subsequently returned for correction (RTPd) and not corrected until after day 5, which date will be used to determine timeliness?” one hospice asked, according to CGS’s Frequently Asked Questions on the topic. “When an NOE is corrected out of the RTP file, it will receive a new receipt date. This new date will be used to determine timely submission of the NOE,” the MAC answers.
 
Another example: Is “processing time calculated in the five-day timely filing of the NOE?” another hospice asked. “The date being used to determine if the NOE is timely is the receipt date (REC DT) assigned by FISS. Typically, this is the date the NOE was submitted in FISS,” CGS replies in the FAQs. “An NOE does not need to reach P B9997 to be considered accepted,” CMS says in a separate FAQ.
Note: Links to the FAQs and multiple other NOE filing resources are at http://cgsmedicare.com/hhh/pubs/news/2015/0615/cope29538.html.

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