Recertification (Follow-up): M0100 – RFA 4 o This assessment must be conducted using OASIS-D1. If the assessment is completed on 12/27/19-12/31/19, for (M0090), enter the artificial date “1/1/2020”. If the assessment is completed in 2020, for (M0090), enter the actual date the assessment is completed.
RECERTS PDGM D1 – Artificial date of 01/01/2020 Read More »
For claims with dates of service of 1/1/2020 and after, HHAs will need to submit a PCR for each 30- day billing period. When requesting more than 30 days of services, the HHA can select the multiple episode/billing period option and submit two or more 30-day billing periods at the same time. In eServices, HHAs
IMPORTANT: TEXAS HHA’s Review Choice & PDGM every 30 days Read More »
Each quarter, the Fiscal Intermediary Shared System (FISS) is updated to include new logic for claims processing, pricing, etc. When the release is installed, Palmetto GBA places a temporary “hold” to ensure the release is installed properly. During this time, claims with dates of service of January 1, 2020, or later will be held in
January 2020, Quarterly Release Temporary Hold Read More »
For the upcoming January 2020 Release, the Common Working File (CWF) will be observing Dark Days starting Friday, January 3, 2020, through Sunday, January 5, 2020. The Dark Days are needed to ensure the completion of weekly, monthly and quarterly processing and the installation of the January 2020 Release. The Dark Days will not affect your ability
January 2020 Release Dark Days for the Common Working File (CWF) Hosts Read More »
Medicare Administrative Contractors (MACs) typically hold claims for a brief period each quarter when they implement system releases. This January, home health Requests for Anticipated Payment (RAPs) are affected by implementation of the Home Health Patient-Driven Groupings Model. MACs will hold RAPs with From Dates on or after January 1, 2020, and process them once
Home Health RAPs: Hold Starting January 1, 2020 Read More »
Message to HHA Providers: As of October 1, 2019, due to the implementation of CR 10776, Home Health Agencies (HHAs) may have received a demand letter for a Request for Anticipated Payment (RAP) overpayment. This letter instructed HHAs to either write a check to the MAC, request an immediate offset, or rebill the RAP if
Palmetto GBA Update Demand Letters Read More »
Update 10/21/2019: CMS reschedules next phase of Home Health Review Choice Demonstration (RCD) To allow Home Health agencies to transition to the Patient-Driven Groupings Model (PDGM), which becomes effective on January 1, 2020, CMS is rescheduling the implementation of the Home Health Review Choice Demonstration (RCD) for the remaining states of Texas, North Carolina, and
Review Choice Demonstration for Home Health Services Read More »