CMS Updates Home Health Claim Processing Instructions for Unsolicited Responses

The Centers for Medicare & Medicaid Services (CMS) recently updated the claims processing instructions for Medicare Administrative Contractors (MACs), including instructions for processing multiple unsolicited responses on the same home health claim. Prior to the implementation of PDGM (Patient Driven Groupings Model), there was no need for multiple unsolicited responses to be processed during the…

CMS Open Door Forum: Updates on PDGM, Claims Processing Issues, Quality & More

On February 26, the Centers for Medicare & Medicaid Services (CMS) held its monthly Home Health, Hospice and DME Open Door Forum (ODF).¬† Following are updates related to the home health agency portion of the call. PDGM CMS reviewed two MedLearn (MLN) Matters articles recently issued that provide information and education on the Patient Driven…

CMS Issues Instructions for PDGM Claims Processing

The Centers for Medicare & Medicaid Services (CMS) has issued Change Request 11081, which provides claim processing¬† instructions to the Medicare Administrative Contractors ( MACs) that will be necessary to process home health claims with the implementation of the Patient Driven Groupings Model (PDGM). The PDGM will assign 30-day periods of care into one of…