February 1, 2010, Home Health & Hospice Medicare A ... - CGS

Example 1: ABC Home Health is admitting a new patient and checks the ELGH screen for Medicareeligibility information. In this example, the current date is entered in the ‘APP DATE’ field. If the ‘APPDATE’ field is left blank, the same results will display.ELGH CWF PART A ELIGIBILITY SYSTEM ELGASAT101/08/2010 14:23:00 INQUIRY BY HOME HEALTH AGENCYENTER THE FOLLOWING FIELDS:HIC NUMBER : 123456789ASURNAME : SmithINITIAL : JDATE OF BIRTH : 01011920 (MMDDCCYY)SEX CODE : MREQUESTOR ID : 0011INTER NO : 00011NPI INDICATOR :N-NPI or BlankPROVIDER NO : XXXXXXHOST-ID : GL, GW, KS, MA, PA, NE, SE, SO, SWAPP DATE : 01082010 (MMDDCCYY)REASON CODE : 1RESPONSE CODE : PThe most recent hospice benefit period, 09/26/2009 – 11/24/2009 displays because the ‘TERM DATE’ of11/24/2009 is within 6 months prior to the current date of 01/08/2010, which was entered in the ‘APPDATE’ field.ELGH CWF PART A ELIGIBILITY SYSTEM ELGHCRO01/08/2010 14:23:33 HOSPICE INFORMATION PAGE 09 OF 09HOS-REC CN 123456789A NM SMITH IT J DB 01011920 SX MHOSPICE PERIOD 1 PERIOD 2 PERIOD 3 PERIOD PERIODSTART DATE 05/29/2009 07/28/2009 09/26/2009TERM DATE 07/27/2009 09/25/2009 11/24/2009PROVIDER NO XXXXXX XXXXXX XXXXXXINTER NO XXXXX XXXXX XXXXXREVOC INDNote in Example 1 (above) that a revocation indicator does not display in the ‘REVOC IND’ field.Therefore, it is possible that the beneficiary is still receiving hospice benefits. To determine if thebeneficiary is enrolled in a more recent hospice benefit period, you need to enter a future date in the ‘APPDATE’ field. Refer to Example 2.Home Health & Hospice February 1, 2010 44Medicare A Newsline Vol. 17, No. 5