Are You Using the Correct Influenza Vaccine HCPCS Code?

Home health and hospice providers should verify with their clinical and billing staff that they are using the correct influenza vaccine HCPCS code when submitting claims for the administration of the influenza virus vaccine. The Medicare Administrative Contractors (MACs) have begun notifying providers of incorrect usage since they have received claims with hospital-specific codes.

Home Health and Hospice providers (PPS) should utilize code G0008 on claim submission for Influenza Virus vaccines.

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Determining Home Health Medicare Eligibility for Home Health Services

Before providing home health services that will be reimbursed by Medicare, it’s important for agencies to determine home health Medicare eligibility. Having the tools you need to verify home health Medicare eligibility and provide quality care allows you to put patients before paperwork.
What Determines Home Health Medicare Eligibility?
Medicare eligibility for home health services requires the following criteria to be met:

The patient must be receiving services under a care plan established and reviewed regularly by a doctor.

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New QAO Quality Reporting Requirement for Home Health

Start Date Begins This Week.
The Centers for Medicare and Medicaid Services (CMS) instituted payment related quality reporting requirements for home health agencies in regulation 42 CFR 484.250(a) several years ago. Since that time, agencies that have failed to report OASIS data and comply with Home Health Care Consumer Assessment of Healthcare Providers and Systems Survey (HHCAHPS) requirements have been subject to 2% reduction in their annual market basket update.

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New HHA PEPPER Tool Available Soon for Home Health Providers

This summer, Home Health Agencies (HHAs) will have the benefit of a new tool to help assess the risk for improper Medicare Payments. The TMF Health Quality Institute is developing a new HHA PEPPER report.
PEPPER, which stands for Program for Evaluating Payment Patterns Electronic Report, provides provider-specific Medicare data statistics for discharges/services vulnerable to improper payments.

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HEALTHCAREfirst Announces Business Intelligence Enhancements That Help Reduce Medicare Denial Rates

Ozark, Mo. – July 2, 2013 – HEALTHCAREfirst, the pioneer in Web-based software and services for home health and hospice care, today announced important Business Intelligence Enhancements, the industry’s leading online analytics tool for home health agencies that can help reduce denials of the most common HIPPS codes.
Earlier this year, Palmetto GBA announced new medical prepay audits based on certain HIPPS codes that have the highest denial rates.

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Medicare Comparative Billing Reports

Home Health Business Intelligence Tool is the Perfect Partner.
Recently, you may have received a Comparative Billing Report (CBR) from Medicare.  What are they being used for?  And how should they be interpreted and used by home health agencies?
Who Produces the Medicare Comparative Billing Report?
CMS contracted with two companies to produce these specialized reports: SafeGuard Services,

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New Legislation Complicates Home Health Care for Medicare Patients

Medicare Patients Home Health Face-to-Face Rule.
Physicians are disturbed by new Medicare mandates demanding lengthy justifications describing Medicare patients’ qualifications for Home Health Care and Hospice Care under Medicare coverage standards, according to a new survey.
Conducted by the independent polling firm, Fabrizio, Ward & Associates, results from this National Association for Home Care and Hospice (NAHC) poll show physicians believe this new Medicare rule will create destructive bottlenecks in the system it has been purportedly fighting to simplify.

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