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Home Health & Hospice Week

Policies & Procedures:

Add This Step To Intake Or Risk Entire Episode Reimbursement

Updates to the list increased to twice per week.

Waiting to check PECOS when it’s time to bill is too late.

Under the so-called PECOS edits that will take effect in January, home care providers will have to add referring physicians’ PECOS check, "like patient eligibility, to their list of ‘to dos’ before they proceed to the assessment," advises Lynn Olson, owner of billing company Astrid Medical Services in Corpus Christi, Texas.

Perform the check using the Centers for Medicare & Medicaid Services’ PECOS list, the "Order-ing and Referring Report," online at www.cms.gov/Medicare/Provider-Enrollment-and-Certification/ MedicareProviderSupEnroll/MedicareOrderingandReferring.html — scroll down to the "Downloads" section to access the report via PDF or CSV file. The report contains "the National Provider Identifier (NPI) and legal name (last name, first name) of all physicians and non-physician practitioners who are of a type/specialty that is legally eligible to order and refer in the Medicare program and who have current enrollment records in Medicare (i.e., they have enrollment records in PECOS)," CMS explains on the site.

CMS will update this report twice a week, up from the previous weekly update.

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