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Medicare cuts and billing denials affect hospice budgets

On Behalf of | Nov 15, 2022 | Health Law Attorneys, Medicare Reimbursements

Hospice providers have struggled under the 2014 Budget Control Act. The act reduced Medicare payments to hospice providers and others when the facilities failed to include specific data. The 2% cuts force health care services to work harder to receive complete payments for the care they offer. Texas hospice professionals strive to help all the patients who need their care, but they must receive reimbursement for the work provided to cover their costs and maintain their practices.

Errors cause delays

Any billing error can result in a claim denial and extra hours needed to collect the balance owed to the health care facility. Delays reduce what a company has for operating expenses and can force a hospice service to turn away patients when they lack the staff or supplies to care for them.

Vigilance prevents losses

Detailed recordkeeping remains the best tool every hospice has available. Hospices must ensure every invoice they present has accurate and well-documented billing information. Avoid duplicate billing, poor record keeping, and other mistakes that make Medicare denials possible or prevent them from collection after a denial.

Details always matter

Hospice Item Set (HIS) audits have presented an opportunity for busy providers to make mistakes. This hospice law collection covering admission and discharge records for every patient, even non-Medicare patients, can prove costly if not completed correctly and on time. Not following the process can result in a 2% cut on the charges billed for a specific patient and across the board.

As some agencies fight for increases in Medicare payments to health care service providers, others fight for more cuts. The suggested increase in pay may not provide the help needed as they struggle to cover the rising material costs due to supply chain shortages and inflation. Remaining cautious to prevent billing errors and staying focused on collection from Medicare for legitimate claims is the option hospice administrators have to keep their finances under control.