HCFA announces toll-free hotlines, target billing education

By MATTHEW HAY

HHBR Washington Correspondent

WASHINGTON Health Care Financing Administration (HCFA; Baltimore) Administrator Nancy Ann DeParle notified 9,000 home health agencies last week that HCFA plans to establish toll-free hotlines for agencies and other providers with questions about proper billing and other issues.

She reported that the agency is also testing new evaluation and management guidelines and measuring and identifying payment errors for each Medicare claims-processing contractor to better campaign, as well as other efforts at further reducing Medicare’s payment error rate.

In her June 1 letter, DeParle cited common payment errors and urged home health agencies to prevent errors by providing adequate documentation. For home health agencies, the two most common errors were failure to document the need for skilled nursing visits beyond 21 days and/or document that the need for skilled visits is finite and predictable, and failure to obtain dated physician certifications, she noted.

HCFA says the letters are the latest step in its on-going efforts to reduce errors, which DeParle noted have already reduced Medicare’s payment error rate almost 50% in three years. Medicare’s payment error rate was 8% last year, compared to 14% in 1996, the first year of the audit. The agency’s long-range Government Performance Review Act goal is a 5% rate by FY 2002.