Our Products can help your organization stay educated and compliant. Shop Now >


CMS Proposes to Begin Pre-Claim Review Choice Demonstration on December 10, 2018 in IL

Posted on Friday, September 28, 2018 6:58 PM

CMS has issued a second Paperwork Reduction Act (PRA) notice for public comment for the Home Health Pre-Claim Review Demonstration.  It is for a 30-day public comment period.

Initially, CMS plans to implement the demonstration in Illinois, Ohio, North Carolina, Florida and Texas.  CMS plans to begin on December 10, 2018 in Illinois.

Providers in these states can to either 100 percent pre-claim review or 100 percent post-claim payment review.  They will be subject to a review process until HHA reaches the claim approval rate.  Once reached, they can choose to be relieved from claim reviews.

Providers also have an option to opt out of 100 percent pre or post-claim review by completing services and submitting a claim for an automatic 25 percent reduction in reimbursement and potential review by the Recovery Audit Contractor.

Source: NAHC Report

About Corridor

Corridor is the nation’s preferred partner and trusted business advisor to home health and hospice providers, providing quality services and impactful results for 30 years. Focusing on key operational, regulatory and financial challenges, Corridor delivering industry-unique solutions and deep expertise in coding, clinical documentation review, compliance, billing and collections , consulting and provider staff education . At Corridor, we make the business of caring for people Better! For the most important industry updates and news that impacts home health and hospice, please make sure to sign up for our weekly newsletter to receive the latest up-to-date industry information direct to your inbox!

For additional information, please contact Corridor at 1-866-263-3795.

Go Back