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Battling Medicare Secondary Payer Claims

Medicare Secondary Payer (MSP) is the term used when Medicare is not the primary paying party. Heartache swirls around MSP claims for a variety of reasons, mainly because these claims are complex, need manual work and take the time from your busy billing team that it doesn't have.

Managing Home Health ADRs for Optimal Reimbursement

In our last blog post, we outlined common causes of Additional Development Requests (ADRs) and offered tips to prevent them. We even included a special home health agency final claim checklist to help you submit an end-of-episode claim correctly to avoid an ADR and speed up reimbursement.

Prevent Home Health ADRs before they Cost You Time and Money

Additional Development Requests (ADRs) are a fact of life for home health agencies. Since CMS renewed its Probe and Educate, now called Targeted Probe and Educate (TPE), preventing ADRs and responding to them in a timely fashion is even more important to the financial health of your agency.

Infographic | Top 6 Home Health Denial Reasons Based on Medical Review

Accuracy and oversight matter in home health billing. Agencies must be on top of their business practices to avoid denials. This includes managing detailed documentation procedures and the most accurate billing processes possible. Knowing the top reasons home health agencies receive denials based on medical review and how to avoid them will keep your agency on top of its reimbursement game. Check out our infographic to learn more.

Bill Well and Prosper - Claims Management and Business Intelligence

Step 3: Claims Management and Business Intelligence

So far in our Bill Well and Prosper blog series, we’ve outlined ways to improve your eligibility and claims submission process for a thriving business. You’ve done everything to secure reimbursement by confirming eligibility and maximizing clean, timely claims submission. Now what? It’s time to manage your claims and embrace robust business intelligence to take your organization and cash flow up a notch.

Redetermination Requests Now Accepted Through esMD

MACs JK (NGS) and J6 (NGS) are now accepting Level 1 appeal (Redetermination) requests through esMD.  A Redetermination request is a request for re-examination of the initial claim decision. It is conducted by the MAC or DME MAC.