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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