Understanding the PEPPER Report
The PEPPER report target areas focus on statistics that will identify potential for improper Medicare billing. Comparison to national, jurisdictional, and state percentiles can highlight a hospice agency’s potential need for change to its practices to guard against...
What is Hospice Visits in the Last Days of Life (HVLDL)?
HVLDL is an HQRP claims-based measure of the proportion of patients who have received in-person visits from a registered nurse (RN) or a medical social worker (MSW) on at least two of the final three days of life. This metric replaces the HIS-based measure Hospice...
What is Hospice Care Index (HCI)?
HCI is a single comprehensive metric reflecting ten indicators of care delivered during a hospice stay -- from admission to discharge. This metric, which is included in the patient Care Compare portal, is intended to provide patients, families, and caregivers...
Must every hospice participate in the CAHPS hospice survey?
What is the CAHPS hospice survey? The CAHPS hospice survey is administered to eligible caregivers after a patient’s death to measure the quality of care and communication provided by the hospice. A hospice agency must participate in the CAHPS Hospice Survey to be...
Selecting a CAHPS Hospice Survey Vendor
Why should a hospice agency use a CAHPS Hospice Survey vendor? A hospice agency is not permitted to administer its own CAHPS Hospice Surveys. Instead, every hospice agency is required to contract with an approved CAHPS Hospice Survey vendor. The vendor will administer...
Hospice Acronym Alphabet Soup
Are you confused by the Acronym Alphabet Soup? Does the never ending list of acronyms used in the hospice and healthcare industry leave you confused? Are you worried that you may confuse CMN with CMP? To help sort out the confusion, we add here links to lists of...
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...
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...
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....
Aging Accounts Receivable
What is Aging Accounts Receivable? The age of accounts receivable (AR) is the time that has elapsed from the time the agency delivered the service to the patient until current date. Aging AR is typically grouped into monthly buckets (e.g., 0-30 days, 31-60 days,...