In 2015, home health claims had a 59 percent improper payment rate, and a large proportion of the improper payment rate was because of insufficient documentation. The Centers for Medicare and Medicaid Services (CMS) is going to implement a pre-claim review demonstration of home health services in 5 states to help educate Home Health Agencies (HHA) on what documentation is required and encourage them to submit the correct documentation, while still allowing the HHA to begin providing services and receive initial payments prior to the pre-claim review decision.
For additional information on how the pre-claim review process will work and to see what 5 states are included in the demonstration project, click
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