Improper Payment Rates for Home Health and Hospice Providers Decreased in 2019

Posted on Friday, January 3, 2020 8:01 PM

Home health providers saw a drop of 5.5% on improper payment rates in 2019 to 12.1% down from 17.6% from the previous year.  Non-hospital-based hospices improper payment rates dropped 2.1% to 8.9% while hospital-based hospices say a drop of .4% to 18.9%.

The most common reason for improper payments, for both home health agencies and hospices, is insufficient documentation.  Medicare had a 92.7% payment accuracy rate with 7.3% improper payments, reflecting a decrease in overall improper payments of 0.8% from last year.

The report cites five common causes for improper payments:

  • insufficient documentation;
  • medical necessity;
  • incorrect coding;
  • no documentation; and
  • other

The report further breaks down insufficient documentation into more detailed categories that include:

  • certification/ recertification;
  • inconsistent records;
  • missing/inadequate orders;
  • missing/ inadequate plan of care;
  • missing/ inadequate records;
  • multiple universal errors (a combination of any of these categories).

Source: NAHC Report

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Corridor is the nation’s preferred partner and trusted business advisor to home health and hospice providers, providing quality services and impactful results for 30 years. Focusing on key operational, regulatory and financial challenges, Corridor delivering industry-unique solutions and deep expertise in coding, clinical documentation review, compliance, billing and collections , consulting and provider staff education . At Corridor, we make the business of caring for people Better! For the most important industry updates and news that impacts home health and hospice, please make sure to sign up for our weekly newsletter to receive the latest up-to-date industry information direct to your inbox!

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