HOSPICE DENIAL IN MEDICAL BILLING CO B9
Автор: PKR Vibes Career & Growth
Загружено: 2022-07-21
Просмотров: 9176
Patient enrolled in a HOSPICE. Reason Code: B9
Scenario Description:
#hospice : Providing CARE, COMPASSION & DIGNITY to our elder, who are nearing to “End of their life”. Denial code is CO-B9.
Case 1: Medicare(MCR) denied the claim stating Patient is enrolled in a HOSPICE.
Step1: Verify patient’s eligibility, noted the MCR’s Hospice effective dates for Dos.
Step2: Append GW Modifier (GW : Provider related to Hospice but services not related Hospice) & Submit claim to MCR. So that Doctor will get payments from payer.
Case 2: Medicare(MCR) denied the claim with same reason(already GW appended).
Step1: Verify patient’s eligibility, then will see other Hospice care details(Hospice care name, Hospice dates…….etc)
Step2: Remove GW Modifier, Add & Submit the claim to HOSPICE CARE* .
Note1: if patient has MCR eligible, MCR PART A will cover/pay Hospice coverage.
Note2: If patient has no MCR coverage, individual Hospice care* will pay.
Note3: If eligible State Medicaid will also pay.
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