It’s essential to be aware of potential pitfalls that come with the unique complexity of billing hospice claims. Since providers are only allowed to bill one claim per month per beneficiary, the importance of timely filing and careful claim tracking is essential to ensure there are no major delays in reimbursement.
The key to streamlining sequential billing is to address problematic claims as quickly as possible before billing for the continuing claims in the series. Following the steps below ensures a smooth billing process for your hospice claims.
Submit the Notice of Election (NOE) to the DDE to notify Medicare of the dates the beneficiary elected to hospice benefit. Providers must process the NOE within 5 days of the administration date. If possible, use available technology that helps you manage and expedite the process. The NOE must be in paid status before moving to the next step.
Providers must submit the first claim in the series after patient discharge or at the beginning of the month following the provided services. Make sure the claim’s service dates match those previously submitted on the NOE. If they don’t match, or the claim is submitted before the NOE is processed, the claim will be labeled as RTP status. Monitor submitted claims carefully for unresolved issues and quickly address them to avoid delaying next month’s billing.
You’re in the clear to submit continuing claims in the series. It is crucial to compare the dates of this claim and the previous claim match consecutively. The To date on one claim is required to fall on the last day of the calendar month unless the patient has been discharged or passes away. Claims that span more than one month’s time (Jan 1 Feb 1) will be filed as RTP and sent back for correction.
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