Ensure Your Agency Submits Required Patient Assessment Information for Home Health Claims

CMS has released a special edition of MLN Matters to help home health agencies make sure claims match the corresponding OASIS assessment successfully.

Before submitting an HH claim to your MAC, agencies should ensure the OASIS assessment has completed processing and was successfully accepted into iQIES. You can verify this by reviewing your OASIS Final Validation Report (FVR). Additional information concerning OASIS submission and the FVR is available here.

If a claim is submitted and Medicare systems do not find the matching assessment, the claim is Returned to the Provider (RTP) with FISS reason code 37253. Typically, there is no need to call the iQIES help desk for assistance in resolving this reason code.

Read the MLN Matters Article to learn the steps you can take to resolve reason code 37253. If you need further assistance, contact us today! We work with home health agencies of all sizes across the country. We will make sure you get the money you earned as quickly as possible!