tci Medicare Compliance & Reimbursement - 2012 Issue 14

Home Health and Hospice: Banish Medical Necessity Denials With These Expert Pointers

Stop risking reimbursement by understanding coverage rules and properly training and supervising staff.With reviewers examining medical necessity more closely than ever, you need to heed what the experts have to say on fending off denials: 1. Read the manual. The Medicare Benefit Policy Manual (Pub 100-02) Chapter 7 is your Medicare coverage bible, and you should know it practically by heart, experts agree. Consultant Lynda Laff with Laff & Associates in Hilton Head Island, S.C. also recommends reading the Medicare Claims Processing Manual (Pub 100-4) "to better understand the rules and criteria for billing." Home Health...

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