Our audit reviews continue to reveal the same key issues: eligibility, certification, and documentation. Medicare home health coverage isn’t just about providing care—it’s about clearly demonstrating the medical necessity through accurate and timely records. Home Health Eligibility: All Criteria Must Be MetTo qualify for Medicare home health services, the patient must: Plan of Care (POC)…
Tag: ADR
Navigating ADRs
Do you struggle with how to navigate Additional Development Requests (ADRs) and ensure accurate reimbursement? These tips will help put you on the right track. Understand the Purpose of ADRs: ADRs occur when payers request additional documentation to justify payment for specific services. Focus on the most common type: Pre-Payment Medicare Approved Contractor’s (MAC) “medical…
Approved Signatures
Services and orders provided for home health and hospice require some kind of authenticating signature by the author. In this age of electronic medical records, organizations are faced with a variety of signatures–handwritten and electronic. It’s often difficult to determine what is acceptable to the Medicare Administrative Contractors (MACs). Here are a few tips. First…
Additional Document Requests
Additional Document Requests (ADRs) strike fear into the hearts of most home health and hospice providers. One of the leading reasons for claim denial results from providers not responding to ADRs. That, in itself, will lead to more scrutiny. Providers need to ensure they have a clear cut ADR process including prompt identification of the…
