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CMS Announces the Delay of the Pre-Claim Review Demonstration

Posted on Wednesday, September 21, 2016 1:15 AM

After months of constant push back and concern for the home health services in five states, CMS announced that they are no longer moving forward with implementing the Pre-Claim Review Demonstration in Florida, Texas, Michigan and Massachusetts. Although Illinois will still feel the wrath of Pre-Claim Review, the other agencies are celebrating.

CMS explained that “this education effort will focus on how to submit Pre-Claim Review requests, documentation requirements, and common reasons for non-affirmation.”

Corridor’s Business Development Manager, Jason Jones stated “I agree with the delay. Until the process is fixed and able to handle millions of reviews, agencies shouldn’t have to bare this burden while the MACs iron out the details.”

For now, the demonstration has been delayed. However, CMS will notify the additional states with a 30-day notice prior to the start of the additional states. With that being said, Florida is still next on the list.

Jones went on to say that, “agencies should still take this very seriously and implement a plan before the end of the year. Medicare has just delayed the start dates, not cancelled the program.”

If/when the Pre-Claim Review Demonstration is reinforced, Corridor is here to help.

Corridor offers a variety of services to help you navigate through the CMS requirements – including:
• Readiness Assessment
• Outsourced Services
• Documentation Review

Call Corridor today for help with Pre-Claim Review. 1-866-263-3795

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