Timely filing of Notice of Election
A hospice must file a Notice of Election (NOE) within five days after the beneficiary’s hospice admission date.
What is considered timely filing of an NOE?
For an NOE to be considered timely:
- The NOE must have a receipt date within five calendar days after the hospice admission date
- The NOE must process and finalize in status/location P B9997
For example:
- Patient admitted on 5/8
- NOE submitted on 5/13
- NOE processed on 5/27
To be timely, the NOE must have a receipt date of 5/13 and the NOE must subsequently process (P B9997)
However, if the NOE is not filed timely, Medicare will not cover and pay for the days of hospice care from the date that the patient is admitted until the date the NOE is submitted and accepted. For example:
- Admission date: 5/1
- NOE receipt date 5/10
- NOE processed 5/18
Non covered days: 5/1 through 5/9 (one day before NOE receipt date)
- Admission date 5/1
- NOE receipt date 5/10
- NOE processed 5/18
Non covered days: 5/1 through 5/9 (one day before NOE receipt date)
What happens if a hospice must resubmit an NOE due to errors?
Sometimes an NOE is submitted but it is not accepted due to a need for corrections. The NOE is “RTPd” (Returned to Provider) and is then resubmitted by the hospice. The date that the NOE is resubmitted by the hospice is considered the submission date.
How should a hospice file a claim if the NOE was filed late?
If a hospice has a late NOE, the claim must be filed showing the late filed NOE. It must also show occurrence code OSC 77, indicating the non covered dates. The claim will have two rows, one row for the non-covered days and one row for the covered days.
See Submitting Claims for Untimely NOEs for more details on billing when NOEs are untimely.
For more information on submitting claims, read some of our posts here Hospice Keys Billing Blogs
How to Submit a Notice of Election
What is a Notice of Election?
When a Medicare beneficiary elects hospice services, the hospice must complete an election notice with the beneficiary and file a Notice of Election (NOE) with Medicare.
When must a Notice of Election be submitted?
A hospice notice of election must be submitted and processed prior to submitting the first hospice claim. Beginning October 1, 2014, Medicare has implemented a requirement that the hospice agency must file a NOE within 5 calendar days after the date of the hospice election notice.
In addition to filing the NOE, the NOE must be accepted by the Medicare claims system. For an NOE to be accepted, it must be a “clean submission.” That is, the NOE may not have any errors.
If the NOE has any errors, it will be returned to the provider (RTP’d) for correction. When the provider corrects and resubmits the NOE, the NOE will be assigned a new received date. This new date will be used to establish timely filing with respect to Medicare’s five day requirement.
There are three ways that a hospice provider can submit an NOE
– Using Direct Data Entry (DDE):
DDE is a real time Fiscal Intermedicary Shared System (FISS) application that gives hospice providers the ability to submit claims, monitor the status of claims, and correct claims. It can also be used by providers to monitor claims and requested documentation and to check beneficiary eligibility information.
Providers can manually enter the NOE into DDE via the different relevant screens.
– Submit electronically:
This option became available effective January 1, 2018. The hospice industry requested requested that Medicare implement NOE submission via Electronic Data Exchange (EDI), as this would eliminate keying errors associated with NOE (and thus reduce the number of NOEs that were RTP’d for keying errors since the data for the NOE could be exported directly from the patient’s electronic medical record). Note that NOEs should not be batched with claims
– Paper submission on UB-04 claim forms. .
Where can you find detailed information about completing the NOE?
A helpful job aid has been created that provides details on how to complete the notice of election, with details on the different data requirements depending upon the method of submission: Palmetto NOE job aid