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Clarification of the First Level Appeal Decision Letter

WEBSubmit the appeal in writing. Appeal within 180 days of the date the first level appeal decision letter was received. Note : If the provider agrees with the decision, …

Actived: 6 days ago

URL: https://extranet.palmettogba.com/palmetto/jmhhh.nsf/DIDC/8KRLC75821~Appeals~Frequently%20Asked%20Questions

Jurisdiction M HHH

WEBPalmetto GBA has dedicated representatives available to provide technical assistance and answer questions about our secure online portal, eServices. Our …

Category:  Health Go Health

Home Health Agency Prospective Payment System (PPS) Claims …

WEBEffective for periods of care beginning on and after January 1, 2020, the original HHA PPS system is replaced with the Patient-Driven Grouping Model (PDGM). …

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Jurisdiction M HHH

WEBADR Response Calculator; Appeals Calculator; Charge Denial Rate Calculator; Home Health Agency Prospective Payment System (PPS) Claims …

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Jurisdiction M HHH

WEBReason code 38055 indicates that the claim submitted has exact service dates and at least one revenue code that overlaps a previously submitted claim. …

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Open: Some Home Health Claims Editing for Reason Code 31755

WEB1/23/2023. Status: Reason code 31755 was reactivated on January 3, 2023, and returned claims for: Billing periods for December 2021 that were opened with a RAP and span …

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Home Health Review Choice Demonstration

WEBTake our satisfaction surveys and read about recent enhancements to our tools and services.

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Jurisdiction M HHH

WEBTake our satisfaction surveys and read about recent enhancements to our tools and services.

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Jurisdiction M HHH

WEBToggle navigation Jurisdiction M HHH. Search. Topics

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Home Health and Hospice Coalition Questions and Answers: June …

WEBHome Health Home Health and Hospice Coalition Questions and Answers: June 12, 2023

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Jurisdiction M HHH

WEBThe Home Health Billing Codes job aid includes information to include on claims.

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Jurisdiction M HHH

WEBPublished 06/29/2023. The expedited determination process is afforded to Medicare beneficiaries to dispute the end of their Medicare covered services in certain settings, …

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Jurisdiction M HHH

WEBThe “ Attending ” provider name/NPI entered on the claim should match the physician or NPP name/NPI who signed the home health plan of care. If the physician …

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Jurisdiction M Part B

WEBNote: For office/outpatient E/M visits, the 1995 and 1997 E/M guidelines will no longer be used. The extent of History and physical examination is not an element in …

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Home Health: eServices User Guide and Checklist for Pre …

WEBIf you’re a home health provider submitting pre-claim review requests to Palmetto GBA using the eServices online portal, you would benefit from using a Pre-Claim Review …

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Railroad Providers

WEBThe Railroad Medicare Quick Reference Guide is a publication designed to assist providers with submitting claims to Railroad Medicare. In this guide you can find …

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Home Health: Face-to-Face Documentation Requirement

WEB1. Home Health: Face-to-Face Documentation Requirement. To answer the first question you might document the structure of the lower leg or an issue with the skin of the lower …

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Jurisdiction M HHH

WEBQuestion: It has been brought to our attention that some providers are receiving denials in ADR spot check when the OASIS is submitted greater than 30 days …

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Jurisdiction M HHH

WEBHome Health claims in all demonstration states with billing periods on or after August 31, 2020, will be subject to review under the requirements of the choice …

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