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 »
Overview: CR 10776 (PDF, 192 KB) was issued on May 24, 2019, to require demand letters be sent to HHAs when an overpayment is issued due to the Request for Anticipated Payment (RAP) cancelling when no HH Final Bill was submitted. Background: Prior to CR 10776, if a RAP cancelled because no HH Final Bill
Review Choice Demonstration for Home Health Services UPDATE 10/02/2019: The choice selection period will begin on OCTOBER 16, 2019 and end on NOVEMBER 14, 2019 for Home Health Agencies (HHAs) located in Texas, who submit claims to Palmetto GBA, the Jurisdiction M Medicare Administrative Contractor (MAC). HHAs should visit the Palmetto GBA provider portal [1]
ALERT! REVIEW CHOICE DEMONSTRATION COMING TO TEXAS Read More »