Hospice Conferences: Know These Hospice Claim Requirements To Keep The Cash Flowing

By Author: Angela Martin
Total Articles: 205
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2010 has been a busy year for new claim requirements and the change requests are not over as yet. From itemizing visits to tracking social work phone calls and line item billing for levels of care, if you are not reporting the details right, you could be inviting denials.

Itemize visits per day in billing. The year began with change request 6440 which was effective for service dates on or after January 1.

This new claim requirement changed the way hospice visits are reported, needing line item billing of visits for all service disciplines in 15-minute increments, rather than on a weekly basis.

Each visit on a particular day must now be listed individually. To add to it, you must now bill for therapy services carried out by direct staff and contract staff addressing the terminal.

Track social work phone calls. C.R 6440 also needs that you report medical social services phone calls for providing care to or coordinating care of a patient for the palliation and management of the terminal illness and related conditions. Calls that involve ...
... counseling the patient's family should also be reported. These calls must all be described in the plan of care and documented in the clinical record.

Report two physicians. For claims and notices of election with dates of service on or after April 1, CR request 6540 requires that you report two physicians. The just-in requirement means you must report both the attending doctor and the hospice physician certifying terminal illness.

And this requirement holds true even if the attending physician and the hospice physician happens to be the same individual. In this case, you would list the same doctor's name in both required claim fields.

Use line items for levels of care. You should be providing line item reporting of hospice levels of care for claims received on or after April 29, 2010.

To know more about these hospice claim requirements, sign up for audio conferences. When you sign up for such hospice conferences, you'll know the most common problem areas that plague you on a regular basis so that denials don't come anywhere near you!