Contact us for questions related to compliant billing services through MJS!Clearly hospice utilization is under the watchful eye of the Medicare and Medicaid contactors, particularly in two areas: appropriateness of admission and length of stay for non-cancer diagnoses. But often the external audit results are based upon technicalities that can be caught in pre-billing edits. The MJS Claim DNA program works with the hospice provider to reduce the risk by ensuring that technicalities are resolved before the claim is submitted.
The MJS Account Manager confirms that hospice elections are timely filed through a daily sweep of all admissions. The sweep also timely captures discharges to assure that the CWF is updates, particularly in revocation or transfer situations.
Features of the MJS Claim DNA for hospice include, but are not limited to, the following:
Payor eligibility checked with demographic match-up
81A or 82A filed with Payor
Medicare/Medicaid coverage appropriateness in place at admission/recertification
Notice of election complete and meets requirements
Initial Physician Order includes all services and treatments and includes IDT timely participation
Evidence of Attending Physician involvement in place, when selected
Notice of terminal Illness (narrative) supports hospice admission and recertification
IDT plan of care present and timely updated
Visit encounters meet ordered care
Hospice medications identified for inclusion in claim
Face-to-face completed by qualified NP or MD at required intervals
And much more!
Powerful Healthcare Solutions