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Home Health Agency Billing

Akosua Posted Sat 15th of October, 2011 03:32:34 AM

I will like to know if HHA billing is doneusing cms 1500 or ub92. Also am new at it and needs resources or help. Am startinga new job as HHA Biller

SuperCoder Answered Sat 15th of October, 2011 04:28:22 AM

HHA billing is done using CMS 1450 (UB-04). For your resources, please see below link where you will get the guidelines for processing HHA.

https://www.cms.gov/manuals/downloads/clm104c10.pdf

10 - General Guidelines for Processing Home Health Agency (HHA)
Claims

Akosua Posted Sat 15th of October, 2011 13:13:43 PM

Our state (NJ) does not provide certificate of need for HHA, only medicaid covers the service. However recently all nj medicaid members were ask to switch manditory to HMO and on on eo fthe HMO website it state sto use CMS 1500, that i swhy am very confused. Please advise further.
Akosua

SuperCoder Answered Mon 17th of October, 2011 06:52:05 AM

I researched about this and did not get any such info what exactly you are looking for. What I have posted in my previous answer, that’s the latest info only I am getting from CMS site. However, CMS-1500 could be used in such a scenario where HHA is approved under DME suppliers, so they can submit to MAC using CMS-1500. You are saying it is mentioned to use CMS-1500 in HMO website, but that latest info I am not getting in CMS. These below links might help you for further analysis.
CMS -1450 (UB-04) is used by institutional providers which include Home Health Agency.
CMS-1500, professional paper claim form used by non-institutional provider or supplier to bill Medicare carriers.
http://www.cms.gov/ElectronicBillingEDITrans/15_1450.asp#TopOfPage
http://www.cms.gov/ElectronicBillingEDITrans/16_1500.asp#TopOfPage
Click on Manuals--go to internet-only Manual (IOMs)--Click on Chapter 25 of the Medicare Claims Processing Manual (Pub.100-04).
Anyone who has any latest update regarding HHA billing claim form, please post here to know the great info and to avoid any confusion further.

Akosua Posted Mon 17th of October, 2011 15:46:25 PM

i totally agree with you , but i called two HMO Horizion NJ health and Health first, spoke to their claims department and they are all saying use CMS 1500.

Nikhil Answered Mon 17th of October, 2011 15:59:56 PM

Ok. Bill as per your payor preference, and check if it gets reimbursed and let's us know for everyone's knowledge.

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