Wednesday, January 10, 2024

HOSPICE DENIAL IN MEDICAL BILLING CO B9 #healthcare #medicare #claim #denial #hospital #hospice

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Client registered in a HOSPICE. Factor Code: B9

Circumstance Description:
#hospice: Providing CARE, COMPASSION & DIGNITY to our senior, who are nearing to “End of their life”. Rejection code is CO-B9.

* Case 1: Medicare(MCR) rejected the claim mentioning Patient is registered in a HOSPICE.
Step1: Verify client’s eligibility, kept in mind the MCR’s Hospice reliable dates for Dos.
Step2: Append GW Modifier (GW: Provider associated to Hospice however services unrelated Hospice) & Submit declare to MCR. That Doctor will get payments from payer.

* Case 2: Medicare(MCR) rejected the claim with exact same factor(currently GW added).
Step1: Verify client’s eligibility, then will see other Hospice care information(Hospice care name, Hospice dates… and so on)
Step2: Remove GW Modifier, Add & Submit the claim to HOSPICE CARE *.

Note1: if client has MCR eligible, MCR PART A will cover/pay Hospice protection.
Note2: If client has no MCR protection, specific Hospice care * will pay.
Note3: If qualified State Medicaid will likewise pay.
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https://medicalbillingcertificationprograms.org/hospice-denial-in-medical-billing-co-b9-healthcare-medicare-claim-denial-hospital-hospice/

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