Medicare Compliance & Reimbursement - 2011 Issue 11
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Article Overview
This article covers a Medicare contractor update on hospice claim review activity focused on long-stay hospice patients. It is intended for hospice billing and coding staff, compliance teams, and others tracking payer edits, medical necessity documentation, and reimbursement risk. The piece discusses the general nature of the edits, the denial patterns reported, and the documentation issue highlighted by the contractor.
Why This Topic Matters
Hospice providers need to monitor how claim edits and documentation review can affect reimbursement for long-stay patients. Understanding the scope of the review helps organizations focus on documentation and compliance processes.
Article Sections
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Long-stay hospice claim edits and denial trends
Discusses a Medicare contractor update on claim review activity for hospice patients with extended lengths of stay. Summarizes reported denial trends and the documentation concern identified in the review.
What You Will Learn
- What the article says about hospice claim review activity
- Why long-stay hospice claims may be at risk for denial
- What general documentation issue the contractor highlighted
- Who should pay attention to this hospice billing update
Who Should Read This
- Hospice billing staff
- Coding professionals
- Compliance teams
- Revenue cycle staff
- Medicare providers
Codes Discussed
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