Eli's Hospice Insider

Published on Thu Jan 28, 2010 PDF

The attestation statement for the physician narrative is the latest threat to your certification and billing, but it's far from the only one. Make sure you catch these common cert mistakes that Cahaba GBA sees, before medical reviewers do:

• Predating physician's certification signatures. Certs may be completed up to two weeks before hospice care is elected, the National Hospice and Palliative Care Organization notes in a cert tips sheet. Certs must be secured within two days of hospice election, either verbally or written. Hospices may not submit claims until obtaining written certification;

• Not having both the attending physician and medical director sign the initial certification;

• Not having verbal certifications by both the attending physician and medical director (if applicable);

• No physician(s) signature(s);

• Inability to read or locate a corresponding stamp received date by the physician's signature(s) (if the physician did not date); and

• Not clearly stating the dates/duration the certification period encompasses.

Note: NHPCO's cert tips sheet, which includes examples of the new physician narrative and sample narrative forms, is at www.nhpco.org/files/public/regulatory/Cert-recert_tip_sheet.pdf.

The bottom line: No matter how great the physician narrative is, reviewers will deny your claims if the narrative doesn't include the attestation, Cahaba stresses. And judging from Cahaba's initial analysis, the missing attestations are widespread enough to impact a lot of hospices.

"The problem ... is that there is no grace period," Mahoney notes. "Certifications and recertifications that are lacking the attestation statements are technically non-compliant and the hospices could face some significant payment problems."

Note: To learn more about the hospice cert/ recert requirements, go online to Cahaba's Web site online at www.cahabagba.com/rhhi/coverage/hospice/certification.htm.