Outpatient Facility Coding Alert - 2015 Issue 19
Industry Note: Submit F2F for All Reviewed Claims -- Even Recerts
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Article Overview
This article covers a Medicare contractor update affecting home health and hospice claims under medical review, with emphasis on certification and recertification documentation, face-to-face encounter records, and related supporting materials. It is relevant for billing, coding, and compliance staff who manage claim submissions, documentation requests, and medical review responses. The article also points readers to CMS and CGS resources that may help organize required records.
Why This Topic Matters
Providers need to understand what documentation may be requested when a claim is selected for review so they can reduce denials, delays, and avoidable follow-up requests.
What You Will Learn
- What documentation may be requested when a claim is selected for medical review
- How face-to-face encounter records fit into home health and hospice claim review
- Where to find referenced CMS and contractor resources for documentation support
- How review-related documentation expectations may apply to recertification claims
Who Should Read This
- Home health billing staff
- Hospice billing staff
- Coding professionals
- Revenue cycle teams
- Compliance staff
- Medical records staff
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