NAHC: CMS Allows Resubmission Of Some Hospice NOE/NOTRs To Correct Billing Errors

With the implementation of Change Request (CR) 8877, hospices are now required to submit a Notice of Election (NOE) for hospice patients admitted on or after October 1, 2014 within five days following the date of admission. For hospices that fail to file the NOE on a timely basis, payment will be denied for days of service prior to the Medicare Administrative Contractor’s (MAC’s) receipt and acceptance of the NOE. Additionally, hospices are required to submit a Notice of Termination/Revocation (NOTR) within five days following the date of live discharge, but no penalty for late submission is being assessed at this time.

Many hospices have failed to meet the NOE timely filing requirement because they have submitted NOEs that include errors. To correct these errors, hospices have been required to wait for the NOE to be returned to provider (RTP), after which a new NOE could be submitted. In many instances, the systems time required to process the RTP has meant that a replacement NOE could not be submitted and accepted in time for the hospice to be in compliance with the five-day rule.

Two of CMS’ MACs have recently reported that hospices that discover they have submitted an NOE with a systems-detectable billing error that will cause the NOE to RTP – such as an incorrect HICN – may now immediately submit a corrected NOE rather than having to wait for the RTP process. NAHC has confirmed with CMS that this change is now in effect. CMS also indicated that hospices may immediately resubmit corrected NOTRs, where submitted NOTRs included errors that would otherwise cause the NOTR to RTP. This change will help to reduce the likelihood that systems processing time will result in lost revenue to hospices as the result of the NOE requirement.

For more information from NAHC, click here.

 

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