If the complete affirmation rate or approval rate of HHA applications for the previous six-month period is 90% or more, the provider may choose one of the following review options: 2. Start filing PCR requests on 01.09.2022 for all claims filed from 01.09.2022 with a service date on or after 31.08.2020. Palmetto GBA provides HHAs with a wealth of information that meets the requirements and expectations of the DMC. Browse our collected articles on all aspects of the DMC. Important Note: Any claim with a delivery date of 8/31/2020 or later is subject to the RCD program in North Carolina and Florida. Illinois home health agencies are NOT exempt from exam choice demonstration requirements, but CMS will recognize Illinois agencies that have performed well in the Pre-Claim Review (PCR) demonstration. This means that organizations that received at least 90% confirmation of requests during PCR can choose from the following options at the start of the RCD: As Demonstration of Examination Choice (DMC) continues for Home Health Authorities (HHAs) in North Carolina and Florida, Cycle 4 time is approaching. Illinois agencies that have not received at least 90% confirmation for claims filed during the PCR must choose from one of the “initial” options at the outset of the RCD: CMS has announced plans to deploy the RCD in Alabama, Arkansas, Georgia, Kentucky, Indiana, Louisiana, Mississippi, New Mexico. in Oklahoma, South Carolina and Tennessee over the next two years. If suppliers move from cycle 3 to cycle 4, please inquire about what to do when moving from one selection to another.
1. Continue the PCR process. Data for July and August will be included in the results of Cycle 4. Note: If an HHA is eligible for a subsequent examination option, but does not make a selection during the selection period, the HHA will be included in selection 4. RCCT – RCCU – RCCW – RCCWs – RCCX – RCDC – RCDD – RCDE – RCDI – RCDM Click here to read the CMS Review Choice demo flowchart! For options, which are evaluated every six months, the PCR requests or requests reviewed during the cycle determine the provider`s results. Suppliers will continue in the chosen option during the calculation and selection period. The reporting rate calculation period will take place in July 2022, and result letters will be sent to HHA by the end of July 2022. The selection period for Cycle 4 will run from August 1, 2022 to August 16, 2022. HHAs that do not make selections during this period default to either Option 2 or Option 4, as described earlier in this article. One. Add NTU to claims if PCR has been filed (confirmed or unconfirmed). Discuss! Learn more about how HealthCare Synergy`s RCD services can help you optimize and automate your home care or hospice agency.
Note: We have 144 other definitions of RCD in our acronym Attic. IHHC often hears from suppliers which option is the best choice for RCD. The short answer is that there is no better choice for all providers – you should consider your business model, payer mix, workflow, staff, and claims volume when determining which choice is best for your agency. Here are some key considerations: Home care agencies (HHAs) are subject to Examination Choice Demonstration (CMD). Medicare Administrative Contractors (MACs) are required to review HHA documentation to determine whether beneficiaries meet home health insurance requirements under the Medicare Benefit Policy Manual, Chapter 7 (PDF). Our Home Health Examination (RCD) Choice Demo services ensure that your home health services documentation is suitable for the payment of your choice!. One. The final invoice is adjusted and ADR is generated.