Further, the hospice's fiscal intermediary
was not significantly associated with early hospice disenrollment ([chi square]= 10.4, 8DF, p = .237), but the hospice's fiscal intermediary
was significantly associated with late hospice disenrollment ([chi square] = 21.2, 8 DF, p = .007).
Keywords: Medicare, carrier, fiscal intermediary
, medical necessity, correct coding, medically unlikely edits
Because Medicaid considers its beneficiaries employers of their personal care assistants, the fiscal intermediary
program took care of tax and payroll paperwork for its Medicaid clients, some of whom had more than one personal care assistant, Mr.
Based on past experience, it is likely that each fiscal intermediary
will devise their own policy for handling medical justification.
The plan included a request for $2,400 from the Flexible Career Account fund, granted by the Fiscal Intermediary
I know a lot has to do with our local fiscal intermediary
. CPT code 82948 is described in the 1999 book as "glucose, blood, reagent strip." My billing person tells me this CPT code is identified by HCFA regulations as a "non-billable" item.
HMOs could elect to have their participating hospitals submit standard billing form UB-92 bills to HCFA fiscal intermediaries(7); plans could themselves submit standard UB-92s; or plans could submit an abbreviated UB-92 with fewer elements and fewer fiscal intermediary
These included meetings with our UPHS collaborators regarding staffing, system linkages and marketing options, requests to the fiscal intermediary
for approval of a higher intensity code for the types of patients we were serving, appeal through the regional HFCA office, and contact with local and federal legislators, but all to no avail.
A careful reading of HCFA regulations, recent Medicare fiscal intermediary
guidelines, and JCAHO standards is essential to formulating sound policies and procedures.
After costs accelerated from 1965 to 1974, the federal programs limited payments by requiting that the fiscal intermediary
, one in each state, pay claims based on the basis of 1974 usual and customary fees times the Economic Index Limiter (EIL), an artificial multiplier assigned by the government each year.
* It should include the most up-to-date payment rules for all payers, including: new rules that have yet to be published and distributed, fiscal intermediary
level edits for Medicare rules that refer to that level and plan-level edits for commercial payers (these edits can change on a weekly or even daily basis and require frequent checking for maximum compliance).