Hospice

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  • 1.  Hospice Transfer

    This message was posted by a user wishing to remain anonymous
    Posted 2 days ago
    This message was posted by a user wishing to remain anonymous

    We accepted a hospice transfer on July 1. Yesterday the transferring agency reached out to us and said they discovered an issue on their end and would have to cancel their election.  They said they won't be billing Medicare for their DOS 06/23/26-07/01/26.  They said this will cause our transfer to be invalid and we would need to re-admit as a new admission. They also said that they did ask if they could process it as non-covered but their Compliance Officer said they could not.  

    Does anyone know how we should proceed in this situation? Is our only option to re-admit as a new admission? It doesn't feel right that we should be penalized in this way for accepting a transfer and them deciding to not bill. Thanks for any input! 



  • 2.  RE: Hospice Transfer

    Posted 2 days ago

    That is truly a frustrating situation.

    What is your process for reviewing transfers prior to accepting the patient?

    We do a review of all conditions of payment items like election statement, NOE Addendums and those types of required documentation pieces prior to accepting the patient.

    As for what to do with this patient, I am not sure if it is possible but if you want to try to bill for everything since 7/1 I would recommend doing everything for a new admit without actually DCing the patient.

    Obtain signatures for an election statement, have your provider do a CTI those things so that if CMS says they will not pay for the time between 7/1 and whenever you complete the required documents, you have done them as close to when you realized the error as possible.  I am not sure how this would work for a transfer situation and if CMS would process still the original NOE as the SOC date or how the original agency was submitting their claim correction.

    My understanding unfortunately is by accepting the transfer you accept the risk that if the original election was faulty which leads to you loosing payment.



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    Casey Byman
    Hospice Quality Program Manager
    EvergreenHealth
    Kirkland,WA
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