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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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