CMS recently released an MLN article targeting hospitals and billing for patient care that involves a home health admission.
When patients are transferred, a hospital is typically paid at per diem rate. An OIG report last year found improper payments tied to hospital claims that should have been subject to the transfer policy because the patient received home health services soon after discharge, CMS noted.
The new three-page MLN guidance is geared toward hospital systems, but it is an important reminder to home health agencies to carefully log admission source.
Sharon Harder, president of C3 Advisors LLC in Wheaton, Ill., noted during a DecisionHealth conference last fall that agencies were receiving additional documentation requests (ADRs) related to admission source.
Agencies should make sure they have documentation that led them to their conclusion regarding the admission source, she said. Even if the procedure could be done through a hospital’s outpatient services, if the discharge summary says “inpatient,” that is sufficient documentation, Harder noted. (HHL 10/19/20)