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