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Author Question: List two exceptions to the normal 60-day HHRG-based episode ... (Read 45 times)

Arii_bell

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on: Jul 12, 2018
List two exceptions to the normal 60-day HHRG-based episode payment.

Question 2

Describe the two-installment payment method for the 60-day episode.


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Hikerman221

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Reply #1 on: Jul 12, 2018
Answer to Question 1

Any two of the following: (1) Low Utilization Payment Adjustment occurs when a patient receives four or fewer visits in a 60-day episode. (2) Partial Episode Payment (PEP) occurs when a patient is transferred to another agency for care; PEPs also occur if the agency providing care discharges the patient prior to the end of the 60-day episode and then home care is resumed by the same agency before the end of the episode. (3) Outliers occur when the provision of care to a patient results in unusually high costs to the home care agency.

Answer to Question 2

The first installment is made when a Request for Anticipated Payment is submitted to Medicare, and the second installment is made when the final claim is filed.


Arii_bell

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Reply 2 on: Jul 12, 2018
Thanks for the timely response, appreciate it

xthemafja

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Reply 3 on: Yesterday
Excellent

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