FAQs

Find answers to frequently asked Medicare questions below. You can view additional FAQs for Hospice providers on the CMS website. For help with eServices, view our eServices FAQs.


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Who are the medical directors for Palmetto GBA? 08/05/2020
Are providers required to submit medical records to the Medicare Administrative Contractor (MAC) for Recovery Audit Contractor (RAC) appeals? 07/23/2020
Are there any exceptions for unusual situations regarding the face-to-face requirement? 07/23/2020
As a hospice, are we required to fill out the Medicare Secondary Payer (MSP) questionnaire upon admission and then every 90 days? 07/23/2020
As the office manager/volunteer coordinator for a hospice, can I take a verbal order from a physician for a hospice referral? 07/23/2020
Can a home health agency (HHA) that provides therapy service and a nursing service on the same day only bill one G-code for that day? 07/23/2020
Can a provider remove an incorrect hospice revocation date from a discharge claim? 07/23/2020
Can a therapy assistant provide maintenance therapy visits? 07/23/2020
Can Medicare Secondary Payer and Tertiary Payer claims be submitted electronically? 07/23/2020
Can the face-to-face documentation be included with the plan of care (POC) and certification documentation? 07/23/2020
Does our hospice agency need to submit the notice of election along with the request for additional documentation requests/records? 07/23/2020
Does Palmetto GBA send the provider any communication that states the payment amount due includes the accrued interest for Recovery Audit Contractors (RAC) appeals that have gone to the Quality Improvement Organization (QIO) after the decision? 07/23/2020
Does the Certifying Physician in the Home Health agency record need to be reported on the claim? 07/23/2020
Hospice FAQs 07/23/2020
How are medical record requests handled for the Recovery Audit Contractors (RAC) related appeals/redeterminations? 07/23/2020
How are visits counted for continuous home care (CHC)? 07/23/2020
How do I find out why a claim has been returned to the provider (RTP) for correction? 07/23/2020
How do I know if Medicare is primary or secondary? 07/23/2020
How do we handle billing when an HMO patient, who is receiving home health services from us, disenrolls from the HMO and is eligible for Medicare? 07/23/2020
How long should a home health agency retain billing records, and where can I find that information? 07/23/2020
I cannot seem to locate your hospice or home health training manuals on the Palmetto GBA website. Are they obsolete? 07/23/2020
I have a lot of claims in 'S' status with reason code 30928. Can someone explain why my claims are being held? 07/23/2020
I have a patient who has an open liability claim on the Common Working File (CWF), but we are seeing him for services not related to the auto accident. How should I file these claims with Medicare? 07/23/2020
I submitted an electronic adjustment to correct a medically denied line, why was the claim returned to the provider (RTP)? 07/23/2020
If a hospice fails to recertify the patient should the agency discharge the patient or use span code 77? 07/23/2020
If a Recovery Audit Contractor (RAC) retracts due to a discussion or internal error, how is Palmetto GBA notified? What are the internal processes and timeframes? 07/23/2020
Provider Contact Center (PCC) Frequently Asked Questions (FAQs): July 2019 - September 2019 07/23/2020
Provider Contact Center (PCC) Frequently Asked Questions (FAQs): October 1 - December 31, 2019 07/23/2020
Provider Contact Center (PCC) Frequently Asked Questions (FAQ): January 1, 2020 - March 31, 2020 07/23/2020
Should our home health agency discharge a patient that elects a Medicare Advantage (MA) Plan (also known as a Medicare HMO)? 07/23/2020
Some of my patients have open insurance records that they say are not valid anymore. Can you close them so my claims will process? 07/23/2020
What claim adjustment reason codes will be attached to a N432 or N469 Remittance Advice (RA) remark code on the remit? 07/23/2020
What is a PTAN? 07/23/2020
What is the Recovery Audit Contractor (RAC) appeal/redetermination process? 07/23/2020
What value code is utilized by home health agencies to report the CBSA? 07/23/2020
When do home health claims qualify for the LUPA add-on payment? 07/23/2020
When should home health agencies use the new condition code D2 on their claims? 07/23/2020
Where can I find information regarding home health patients transitioning from and/or to HMOs? 07/23/2020
Which benefit, Medicare or Medicaid, is responsible for paying for the months of care provided to the beneficiary before the signed election statement was obtained? 07/23/2020
Who qualifies as a non-physician practitioner (NPP)? 07/23/2020
Who should a provider contact about status of refund due to a Recovery Audit Contractor (RAC) retraction letter? 07/23/2020
Why do the links in my email listserv not work? 07/23/2020
Can a Medicare patient receive home health and hospice at the same time? 07/22/2020
How do I make the text larger to make it easier to read? 06/30/2020
After I receive a 277CA will I receive anything else? 06/09/2020
Can I share my DDE ID? 06/09/2020
How can I tell if I am set up for Electronic Billing? 06/09/2020
How do I reset my DDE password? 06/09/2020
How do I restore a remit file? 06/09/2020
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