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Home Health LUPA Threshold: Bill Correctly

Home Health LUPA Threshold: Bill Correctly In a recent report, the Office of Inspector General found that Medicare improperly paid some claims for home health services with 5 to 7 visits in a payment episode. Review the Medicare Home Health Benefit and Home Health Prospective Payment System booklets to...

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MACs Resume Medical Review on a Post-payment Basis

MACs Resume Medical Review on a Post-payment Basis Beginning August 2020, Medicare Administrative Contractors (MACs) resumed post-payment reviews of items and services with dates of service before March 2020. MACs may now begin conducting post-payment medical reviews for later dates of service. The Targeted Probe and Educate program (intensive...

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Temporary Claims Hold

Temporary Claims Hold Author: Michael Tidd LVN, HCS-D, COS-C CMS has directed al Medicare Administrative Contracts (MACs) to hold all claims with dates of service on or after April 1, 2021.  This is an action to avoid withholdings from claims related to the Sequestration Moratorium Extension passed by congress...

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