tci Medicare Compliance & Reimbursement - 2013 Issue 9

Home Health Agencies: Take a Closer Look at Your Agency's PECOS Readiness

Be sure you’re on top of these costly edits before they hit. When Home Health & Hospice MAC CGS analyzed claims from September to February, it found that about three-fourths of HHAs had filed claims during that period which would be denied by the new edits. In contrast, HHH MAC Palmetto GBA found about 40 percent of HHAs filed claims that would fail the edits in January and February. Good news: While many agencies would fail the edits, the number of claims denied is modest. In Palmetto’s analysis, only 2.4 percent of the 2.3 million...

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