MedLearn Matters Special Edition Advises on Hospice-related Services
July 23, 2013 09:51 AM
A special edition article from MedLearnMatters was recently released, SE1321. It advises that Recovery Auditors conducted automated claim reviews of medical services provided as separate services, when the Centers for Medicare & Medicaid Services (CMS) regulation or policy, or local practice, dictates that they should have been billed together, rather than individual services for Medicare patients in hospice care.
The article further alerts providers that they should identify if a beneficiary is enrolled in hospice and document this in the patient’s medical record. The article explains the billing process for items related and not related to the patient’s terminal diagnosis and related conditions for hospice. It outlines how unrelated claims should be billed.
The National Association for Home Care & Hospice (NAHC) and its affiliate, the Hospice Association of America (HAA), remind hospice providers to explain to beneficiaries and their families that once a patient has enrolled in hospice, he or she must contact the hospice to arrange for any services needed. If this does not occur and the hospice does not arrange for the care, then the beneficiary may be financially responsible for the expenses.
NAHC and HAA also encourage hospices to educate other providers in the community on the following two points:
All providers should identify if a beneficiary is receiving hospice services and document this in the medical record, and
How the providers should bill for related and unrelated services