tci Medicare Compliance & Reimbursement - 2013 Issue 6

Home Health Reimbursement: Use 6 Strategies To Avert PECOS Edit Losses

You could pay a steep price if your provider information is incorrect. Now is the time to take action. If your docs aren’t in the Provider Enrollment, Chain, and Ownership System (PECOS) file or when the names don’t match, you’ll get claims denials. When Phase 2 of PECOS edits hits May 1, they’ll slap you with costly denials as opposed to less burdensome returned claims when you have invalid ordering/referring physician information (see related story, p. 41). Smart home health agencies will take these six steps to minimize cash flow delays and financial losses due...

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