We would like to remind providers that the Review Choice Demonstration is quickly approaching with a target date as early as October 1st, 2018. Centers for Medicare & Medicaid Services (CMS) paused the Pre-Claim Review Demonstration for Home Health Services on April 1, 2017, however CMS worked to revise the Demonstration to "offer more flexibility and choice for providers, as well as risk-based changes to reward providers who show compliance with Medicare home health policies".
What this really means is that CMS simply opened three options to scrutinize Home Health Agencies under Medical Review regulations. More importantly you will have to choose the type of review as a Provider....
Pre-Claim Review (PCR),
Postpayment Review, or
Minimal Postpayment Review with a 25% payment reduction for all home health services
Please keep in mind that Gateway Home Health Coding and Consulting specializes in processing initial ADR requests, Appeals and Administrative Law Judge Hearings. Our expert staff is here to help you with any type of review CMS facilitates.
CMS official Demonstration site and Q&As CLICK HERE