Posted on Monday, December 28, 2020
Due to the continuing public health emergency, CMS will be extending the phased-in participation of the Review Choice Demonstration for Home Health Agencies in Florida and North Carolina until 3/31/21.
- Providers may continue submitting pre-claim review requests.
- Claims that go through pre-claim review and are submitted with a valid UTN will be excluded from further medical review.
- Claims submitted without going through the pre-claim review process will process as normal and will not be subject to a 25% payment reduction. These claims may be subject to postpayment review in the future through the normal medical review process.
Providers do not need to take any further action if they choose not to participate.
Corridor recommends clients use this extension to their advantage and get in front of the RCD process to prepare for the inevitable rollout. Kimberly Searcy Gunter, Corridor’s Director of Clinical Documentation Advisory services, sees this as an opportunity for clients to get ahead of the RCD curve. “The documentation required isn’t different but how to present it is. Learn how to create a succinct and polished RCD packet so Palmetto isn’t left guessing. Also take this time to become familiar with the process of submission through eServices and to create your agency’s best practice prior to mandatory go live. Every chart submitted through RCD today is one less post payment review you will have to worry about tomorrow.”
Unsure where to begin or want to learn more RCD? Corridor’s RCD services team is here to help.
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For additional information, please contact Corridor at 1-866-263-3795.