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

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Example 2: A future date of 05/01/2010 is entered in the ‘APP DATE’ field.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 : 05012010 (MMDDCCYY)REASON CODE : 1RESPONSE CODE : PIn this example, only the two most recent benefit periods display because, the ‘TERM DATE’ dates for eachperiod, 11/24/2009 and 01/23/2010, are within six months prior to the date entered in the ‘APP DATE’field.ELGH CWF PART A ELIGIBILITY SYSTEM ELGHCRO01/08/2010 14:44:47 HOSPICE INFORMATION PAGE 09 OF 09HOS-REC CN 123456789A NM SMITH IT J DB 01011920 SX MHOSPICE PERIOD 1 PERIOD 2 PERIOD PERIOD PERIODSTART DATE 09/26/2009 11/25/2009TERM DATE 11/24/2009 01/23/2010PROVIDER NO XXXXXX XXXXXXINTER NO XXXXX XXXXXREVOC INDNote: In Example 2, if the future date of 07/25/2010 or after would be entered in the ‘APP DATE’ field, nohospice benefit period information would display because the ‘TERM DATE’ is not within 6 months priorto the date entered.If you are having difficulty determining whether the beneficiary is in a 60- or 90-day benefit period, wesuggest that you review the ELGA/ELGH eligibility screens again, after your Notice of Election (NOE) hasprocessed (status/location P B9997). Once the NOE is processed, the ELGA/ELGH screens will update toidentify the Start and Term dates of the hospice benefit period to which your admission applies.In addition, the CWF system release also changed how hospice benefit period information is displayed onthe ELGA/ELGH eligibility screens. Previously, the most recent benefit period information was displayedon the left side of the screen. With these changes, the most recent benefit information now displays on theright.The hospice benefit period information is also provided on Cahaba’s Interactive Voice Response (IVR).If you have questions about this information, please call a customer service representative in our ProviderContact Center at 1-866-539-5592.Home Health & Hospice February 1, 2010 45Medicare A Newsline Vol. 17, No. 5
Before You Call Cahaba, Read This!From October 1, 2008, through September 30, 2009, the home health (877-299-4500) and hospice (866-539-5592) Customer Service Representatives (CSRs) answered 51,690 questions from home health and hospiceproviders. Based on a review of the topics most asked during October through December 2009, theFrequently Asked Questions (FAQs) for the top inquiries received in Cahaba’s Home Health & HospiceProvider Call Center (PCC) have been updated. The updated FAQs can be accessed on our Web site usingthe following link: http://www.cahabagba.com/rhhi/faqs/index.htmProviders should use all of our self-service technology tools to resolve their Medicare questions beforecontacting a CSR*. A variety of resources are available to assist you. The FAQs and the “Resources for theMost Common Medicare Part A Provider Questions” Web page are valuable resources to refer to beforecalling a CSR. Additional resources include Cahaba’s Interactive Voice Response (IVR) unit or other selfservicetechnology, Cahaba’s and CMS’s Web site, Cahaba and CMS Listserv messages, and a wide varietyof Internet-based provider educational offerings. Providers without Internet access may request a copy ofthe FAQs or other materials posted to Cahaba’s Web site by calling the Provider Outreach and Educationdepartment at 515-471-7335.In looking at the reasons why home health and hospice agencies most frequently call Cahaba, the five issuesbelow represent 34% of all inquiries received. Please review the following information and use theresources cited prior to calling Cahaba for assistance. If the issue still is not resolved, we would encourageyou then to call the PCC for help.Reason for CallExplain reasoncode assigned toclaim needingcorrection. Thereason codes mostinquired aboutinclude:Number ofPrior to Calling Cahaba:Calls4,774 Review the Top Claim Submission Errors and How to Resolve Webpage, which includes links to “Web help” pages for each of the reasoncodes listed.Hospice37402U5181Home Health311473175538107U538GU538IHome Health & Hospice February 1, 2010 46Medicare A Newsline Vol. 17, No. 5
Page 7: use and while they may serve other
Page 10: The following additional billing re
Page 13 and 14: APPENDIX 1TABULAR PRESENTATION OF T
Page 15 and 16: News from CMS for Home Health Provi
Page 17 and 18: Provider Types AffectedHome health
Page 19 and 20: • For CY 2010, Medicare is modify
Page 21 and 22: procedures since 2005, continue to
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Page 25 and 26: NOTE: When billing for stranded sou
Page 27 and 28: c. Other Changes to CY 2010 HCPCS C
Page 29 and 30: d. Drugs and Biologicals with Payme
Page 31 and 32: separately payable status under the
Page 33 and 34: CY 2010 APCCY 2010 APC Title0395 GI
Page 35 and 36: CY 2010 APC CY 2010 APC Title0375 A
Page 37 and 38: m. Pricer will update the payment r
Page 39 and 40: If you have questions regarding thi
Page 41 and 42: When recording any visit or social
Page 43 and 44: Submit MSP Claims/Adjustments via:W
Page 45: Example 1: ABC Home Health is admit
Page 49 and 50: Reason for CallClaim needingcorrect
Page 51 and 52: Availability of the Provider Contac
Page 53 and 54: Cahaba GBA Learning Corner‣ “Ho
Page 55 and 56: Cahaba GBA Learning Corner‣ “OA

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

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