37402

FISS Narrative
The TOB is equal to a hospice claim and the claim from date is greater than April 1, 1998, and the claim receipt date is greater than or equal to October 1, 2005. There is no claim pending or finalized with a through date one day less than this claim’s from date. The reason code authorization field (claim page 9) does not contain this reason code.

Explanation and Suggestion

  • This hospice claim has been received out of sequence. Reasons for this may include:
    • Prior bill must be processed before resubmitting this claim
    • There is a gap in care dates. Hospice claims will not process when there is a gap in care dates
  • Check FISS/DDE and/or the remittance statement for finalized prior claim:
    • Check dates on previous claim and/or make sure it was submitted
    • Verify that the correct date(s) of service are being billed
    • Ensure that the prior claim is finalized before submitting the next claim
    • Verify there is no gap between the 'to' date on the previous claim and the 'from' date on the next claim

Contact Palmetto GBA JM Part HHH Medicare

Email HHH

Contact a specific JM HHH department

Provider Contact Center: 855-696-0705

TDD: 866-830-3188

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