Posted on Monday, November 9, 2020
CMS has issued a change request to CR11855 – Penalty for Delayed Request for Anticipated Payment (RAP) Submission – Implementation. The Change Request (CR) revision added remittance advice message information related to the No Pay RAP penalty.
“Home health agencies (HHAs) should note that Medicare Administrative Contractors (MACs) will:
- Report the following remittance advice messages for the late submission payment reduction in the Claim Level CAS segment (loop 2100) on Home Health Claims on the 835 ERA o Group Code: CO o Claim Adjustment Reason Code (CARC): 95 (“Plan procedures not followed”)
- Report the following remittance advice messages for the late submission payment reduction in the Claim Level CAS segment (Loop 2320) on Home Health Claims to the 837I COB o Group Code: CO o CARC: 95 (“Plan procedures not followed”) that and we added that information to the article. We also changed the CR release.
The CMS No Pay RAP policy, effective January 1, 2021, will require home health agencies to submit the RAP within five days of the from date for each claim or a penalty will be applied to the final claim that equals 1/30 of the 30 day period claim amount for each day the RAP is late. Although CMS has relaxed the criteria for the submitting the RAP beginning in 2021, HHAs are concerned with their ability to comply with the No Pay RAP requirements and the submission time frame.”
Source: NAHC Report
About Corridor
For over 30 years, Corridor has partnered with home-based care providers, delivering powerful solutions to support the unique challenges of caring for patients in the home. Our team of operating executives, clinicians, and nationally renowned industry experts have run provider organizations and resolved the same challenges you face.
Focusing on key operational, regulatory and financial challenges, Corridor delivers solutions and deep expertise in coding, clinical documentation, compliance, billing and education.
To receive the most important industry updates, insights and news impacting home health and hospice, please make sure to sign up for our weekly newsletter.
For additional information, please contact Corridor at 1-866-263-3795.
