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New Edit for Hospice Medicare Claim Processing

Posted on Sunday, January 6, 2019 5:23 PM

CMS released Change Request (CR) 11049/Transmittal 4187, Ensuring Only the Active Billing Hospice Can Submit a Revocation, which implements a new edit for hospice claims received on or after July 1, 2019.  Currently, the Common Working File (CWF) will allow Notices of Revocation/Termination (NOTR – Type of Bill (TOB) 8xB) if the provider identifier on the NOTR matches the provider on the hospice election period. This occurs even if transfer notice (8xC) or a change of ownership notice (8xE) has changed the billing provider on a benefit period within that election. To prevent errors, an edit is needed in CWF to ensure that only the active billing provider can submit a revocation.  There is no policy change as a result of this CR.

Source: NAHC Report

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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!

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