Palmetto GBA and CGS Tours Texas in Partnership with TAHC&H
In partnership with the Texas Association for Home Care and Hospice, Palmetto GBA is partnering with CGS and is coming to 4 sites across Texas to provide education on Pre-Claim review.
These identical workshops are designed to clarify the pre-claim review process for Medicare participating home health agencies (HHAs) when rendering home health services for Medicare beneficiaries. These workshops will advise providers on the process for submitting documents in support of the final claim.
The following topics will be covered during the workshop:
1. Home Health Pre-Claim Review Model Overview
2. Home Health Type of Bills (TOBs) and Healthcare Common Procedural Coding System (HCPCS) Codes Subject to the Home Health Pre-Claim Review Model
3. Number of Home Health Benefit Period 60-day Episodes of Care
4. Submitting a Home Health Pre-Claim Review Request
5. A Provisionally Affirmed Decision
6. A Non-Affirmation Decision for Incomplete Requests
7. Resubmitting a Home Health Pre-Claim Review Request
8. Claim Submission Where Home Health Pre-Claim Review Was Sought
9. Claim Submission Where Home Health Pre-Claim Review Was Not Sought: The Prepayment Review Process
10. Claim Appeals