Palmetto GBA Releases Updated Provider Q&As

MedicarePalmetto GBA this week released questions from a convening of the Home Health Coalition that took place in Charlotte, NC on June 10. The coalition is made up of state association executives including HCAF’s Bobby Lolley. HCAF requested questions from Medicare providers last month to submit to Palmetto representatives.

Questions and answers cover topics such as the face-to-face encounter requirement, an update on RAP suppression activity, PECOS, Negative Pressure Wound Therapy G-Codes, ADRs, billing, Q-code requirements, medical review and more.

Palmetto also included an  analysis of Q1 2013 claims data for visits per beneficiary by discipline, the average episodes per beneficiary, the average episodes per visit and the average percentage of outliers and LUPAs. Florida claims exceeded the average among Palmetto’s 16-state jurisdiction in all areas with the exception of LUPA claims submitted.

In terms of claim denial rate, Florida far exceeded other states in the percentage of claims denied during Q1 with 83.62%. The 16-state average was 59.18%.

To review the complete report, visit www.homecarefla.org/medicare and download the Q1 2013 Palmetto GBA Home Health Coalition Quarterly Data Report.

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