tci Part B Insider - 2003 Issue 5

MEDICAL REVIEW: Don't Let Bogus Review Policies Fool You

Three Medicare carriers are pressuring physicians to choke off home care visits for patients who need them most. Don't let the trio of miscreants muddy the waters when it comes to certifying home care patients, billing experts advise. Despite what these carriers are saying, there is no limit on the number of home health episodes a patient has. These carriers seem especially confused about the meaning of "intermittent" and the extent of the home care benefit, industry experts contend. Local medical review policies from a New York carrier in February 2002, a New Jersey carrier in July 2002 and...

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