Intake

What is a False Claims Act investigation?

What is the False Claims Act

January 29, 2023 · 8 min read

What is Hospice Item Set (HIS)?

All Medicare certified hospice agencies must submit an HIS Admission and HIS Discharge record on all admissions and discharges from their agency. The report must include all patients, irrespective of payer source, patient age, or location where hospice services were provided. It is recommended that

November 27, 2022 · 3 min read

What is the CAHPS survey?

The CAHPS survey is intended to measure the experience of patients who had died while receiving hospice care and the experience of their primary caregivers.  It surveys informal caregivers – usually family members – of the persons who died under hospice care. The survey is a component of the Ho

November 27, 2022 · 5 min read

What is a hospice PEPPER report?

Program for Evaluating Payment Patterns Electronic Reports (PEPPER) is a data analysis report that has been available for hospices since 2012. This report contains claims data statistics based upon UB-04 claims data submissions for a single hospice agency. The statistics are generated for areas that

November 26, 2022 · 6 min read

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 improper billing. Hospice agencies

November 26, 2022 · 5 min read

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 Visits When Death is Imminent (HVWD

November 13, 2022 · 4 min read

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 with an added metric to support inf

November 13, 2022 · 4 min read

Untimely NOE: Requesting an Exception

September 20, 2022 · 1 min read

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 acronyms: Acronyms commonly found on

September 15, 2022 · 1 min read

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 file this document within the m

September 12, 2022 · 2 min read

How to Submit a Notice of Election (NOE)

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.  A Notice of Election (NOE) is the formal mechanism used to notify Medicare that a beneficiary has e

September 8, 2022 · 2 min read

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 hospice benefits.  The face to f

August 4, 2022 · 2 min read

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 patients who have been on hospice f

August 4, 2022 · 3 min read