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Important Current and Future Hospice Billing Changes Outlined in MLN Matters Article

Posted on Friday, June 22, 2018 7:38 PM

In 2017, CMS announced changes that beginning in 2018 allow hospice providers to electronically submit Notices of Election (NOE) and related transactions and to correct election or revocation dates without needing to cancel all transactions related to the hospice election.

CMS issued an MLN Matters Article that talks about the payment options but also announces the new changes to the way hospice benefit periods are configured in the Common Working File (CWF) to:

  • Reduce NOE timely filing exception requests for providers, by ensuring benefit periods can be cancelled without removing the NOE receipt date.
  • Allow Notices of Termination/Revocation (NOTRs) to be submitted at any time, rather than only when a benefit period covering the revocation date has been created by claims.
  • Reduce workload for providers when reprocessing periods by automatically removing benefit periods when all claims in the period are cancelled.
  • Enable easier implementation of future policy changes by ensuring data in Medicare systems reflect hospice coverage requirements more clearly.

Hospice providers have been slow to transition to electronic submission of NOEs, in part due to some initial hiccups related to systems processing and time frames needed by software vendors to program the changes to their billing software.  It is hoped that the reminders regarding electronic NOEs and correction of election/revocation dates will help prompt transition to more automated processing of these transactions.

These are some changes that hospices should expect:

  • New Election Period File and Screen
  • Benefit Periods
  • Making Changes to Election Period or Benefit Period Information
  • NOTR Submission Changes
  • Void/Cancel Submissions
  • Processing Impacts

Click here to read the full article.

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