Medicare Compliance & Reimbursement

CMS answers about face-to-face requirements raise more questions. That face-to-face documentation you have signed by a resident won't do you any good when it comes to compliance and reimbursement. That's because Medicare doesn't allow physicians who don't have hospital privileges to sign the F2F documentation, said a Centers for Medicare & Medicaid Services official in the April 11 Open Door Forum for home care providers. Residents who don't have privileges must inform their supervising/teaching physician who does have privileges, said CMS's Kelly Horney in the forum. Clarification: CMS is talking about privileges to practice at the hospital, not Medicare billing privileges, CMS's Randy Throndset explained in response to a question from Mary St. Pierre of the National Association for Home Care & Hospice. You'll also want to be leery of F2F documentation from Veterans Administration physicians, Horney indicated. Medicare accepts certification from physicians only when they are enrolled in Medicare, [...]