tci Medicare Compliance & Reimbursement - 2016 Issue 17

Home Health Reimbursement: Watch Out for Cash Flow Delays as PCR Launches

Take these pre-emptive measures to avoid furnishing free care. Pre-claim review (PCR) is slowly ramping up in Illinois. Is your agency ready for the dawn of the 100 percent pre-pay review program? Recap:After somePaperwork Reduction Act-related confusion, the Centers for Medicare & Medicaid Services (CMS) launched PCR in Illinois Aug. 3. Under the program, home health agencies (HHAs) submit a Request for Anticipated Payment (RAP), then a pre-claim review request including all documentation needed to support the claim (including the face-to-face physician visit note), and then the Home Health & Hospice Medicare Administrative Contractor will issue a decision on...

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