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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