Important Update for Home Health Agencies! Penalty for Delayed Request for Anticipated Payment (RAP) Submission

CMS has updated their MLN Matters article concerning penalties for delayed Request for Anticipated Payment (RAP) submissions to include remittance advice messages. The new information is below:

“HHAs should note that MACs will:
Report the following remittance advice messages for the late submission payment
reduction in the Claim Level CAS segment (loop 2100) on Home Health Claims on the
835 ERA
o Group Code: CO
o Claim Adjustment Reason Code (CARC): 95 (“Plan procedures not followed”)
Report the following remittance advice messages for the late submission payment
reduction in the Claim Level CAS segment (Loop 2320) on Home Health Claims to the
837I COB
o Group Code: CO
o CARC: 95 (“Plan procedures not followed”)”

Click here to download the full MLN Matters article, and be sure to share it with your staff!

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