What are the three key financial statements?
Financial statements record an agency’s financial activities and convey the agency’s financial health. Financial statements are often audited by accountants to ensure their accuracy and are prepared in accordance with a specific set of accounting rules called...
Medicare Credit Balance Report
What is Medicare credit balance? A Medicare credit balance represents a Medicare overpayment to a provider due to patient billing error or claims processing error that must be refunded to Medicare. The report is referred to as a Credit Balance Report because when a...
Untimely NOE: Requesting an Exception
Timely filing of Notice of Election
The Notice of Election (NOE) is more than a clinical administrative task; it is a critical financial trigger. In the hospice revenue cycle, the NOE serves as the formal notification to Medicare that an agency has assumed responsibility for a patient’s care. Failure to...
What is a MAC?
A Medicare Administrative Contractor (MAC) is a private health care insurer that has been awarded a geographic jurisdiction to process Medicare Part A and Part B medical claims for Fee For Service (FFS) beneficiaries.CMS relies on these contractors to serve as the...
Unusual Circumstances: Face to Face Encounters
Prior to the third hospice benefit period, and prior to each subsequent benefit period, a hospice physician or nurse practitioner is required to have a face to face encounter with the hospice patient to recertify that the patient continues to be Medicare eligible for...
What is Face to Face Recertification?
A hospice face to face encounter is a step in patient recertification beginning with the third benefit period and each benefit period thereafter. The goal of hospice face to face patient encounter is to encourage greater involvement of the physician in the care of...
Core Services: Using Employees versus Contractors
Hospice Conditions of Participation - employees versus contractors Hospice conditions of participation require that almost all hospice core services are delivered by hospice agency employees and may not be delivered by contractors. Hospice core services include:...
Navigating the Hospice Initial Accreditation Process
What is hospice initial accreditation and why is it important? Hospice initial accreditation is a way to ensure delivery of consistent and high quality services across all accredited hospice agencies. The accreditation program ensures that the hospice agency is fully...
Accounts Receivable by Payer
Who are Hospice Agency Payers? A payer is the company of government agency that pays the provider, i.e., the hospice agency, for the medical service that is administered to the patient. For most hospice agencies, Medicare is the primary payer for hospice services....