Where Hospice Compliance Meets Revenue Cycle Management

Posted Wednesday, August 9, 2023

Regulatory agencies are cracking down on hospice spending, and providers can benefit from recognizing the links between revenue cycle management and compliance.

Meanwhile, CMS has ramped up auditing activity tied to longer stays and more expensive levels of care such as GIP. They have encountered a variety of audit types as CMS contractors conduct post-payment reviews designed to recoup Medicare funds that may have been overspent.

The increased focus on hospice billing and claims has added to the mix of financial pressures that impact providers, according to Zaundra Ellis, vice president of hospice professional services at the health care software provider Axxess.

“There’s a lot of external forces that really could shut down a hospice,” Ellis said during the National Association for Home Care & Hospice (NAHC) Financial Management Conference. “From a compliance perspective with the OIG and Medicare, there’s so much money involved, and we’ve seen so much growth in hospice over the last decade. Key priorities as Medicare expenses in hospice go up are [providers’] billing practices and claims data.”

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