Eli's Hospice Insider
Stay a Step Ahead of the RACsWith 2 Strategies
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Find out how to keep your claims out of RACs' reach. Giving your claims a clean bill of health may be the best medicine for keeping the RACs off your case. Since RACs can request records going back three years, "the sooner a provider identifies its issues and corrects them moving forward, the better," says
Correction your best policy: "Whenever a hospice discovers that it has made a billing mistake, it should seek to correct the problem and make repayment," advises attorney Paula Sanders, partner with Post & Schell in Harrisburg, Pa.
And if the hospice thinks it has a systemic issue with billing, it should consult with counsel and decide whether a voluntary disclosure is the best way to proceed, Sanders counsels.
"If a provider does a self-audit, and identifies and self-reports the improper payments, those claims will be adjusted and excluded from RAC review," she adds.
This exclusion also applies to findings included in a self-disclosure, "as long as the Medicare Administrative Contractor confirms that a payment error exists and the sampling/extrapolation method was correct."
Eli's Hospice Insider
- LITIGATION:
Big Hospice Settlement Puts Industry in the Hot Seat
Hospice eligibility and 6-month prognosis focus of successful whistleblower lawsuit. A hospice chain's $25 million [...] - TRENDS:
MedPAC Pushes Major Hospice Pay Revamp
Industry unhappy about proposal for abrupt change. The Medicare Payment Advisory Commission's newest recommendations take [...] - Compliance:
When Educating Referral Sources About Hospice,Keep Sight of These Compliance Requirements
Operating within these boundaries can make teaching efforts a boon rather than a bane. Stepping [...] - REIMBURSEMENT:
Hospices May Need More Details From Doctors
MedPAC also targets 5 hot spots including nursing home relationships. The new recommendations from the [...] - RISK MANAGEMENT:
Ramp Up for the RACs: Focus onWhat Could Be 3 Easy Targets
Forewarned is forearmed in dealing with these 'bounty-hunter' auditors. If the RAC program doesn't rank [...] - EDUCATION & OUTREACH:
Required Assessment Instruments Hold Key Clues to Who May Be Ready for Palliative Approach
Help nursing home and home health providers use these tools in a new way. Home [...] - Check Out the Personal Severity Index for Nursing Home Patients
• Age 90 or older • Cognitive decision making:severely impaired • Delirium: Periods of lethargy [...] - Risk Management:
Stay a Step Ahead of the RACsWith 2 Strategies
Find out how to keep your claims out of RACs' reach. Giving your claims a [...] - INDUSTRY NOTES:
Don't Delay In ICD-10 Preparation
Health care providers are claiming victory on the ICD-10 implementation schedule, but that shouldn't prevent [...] - Education:
Master Compliance and Reimbursement Topics With These Upcoming Audioconferences
• Providing Continuous Care in Hospice: Should You or Shouldn’t You? Dial in on Tuesday, [...]