HCFA Letters Urge Providers to Help Reduce Payment Errors - Brief Article - Statistical Data Included

Healthcare Financial Management, August, 2000

In letters sent June 1 to 660,000 physicians and group medical practices, 140,000 durable medical equipment (DME) suppliers, and 9,000 home health agencies, HCFA has requested help in ensuring correct payment for Medicare services, In the letter to physicians, HCFA Administrator Nancy-Ann DeParle states that the agency will focus on correct use of CPT codes 99214 and 99233, which are used to report evaluation and management services and account for a significant percentage of coding errors.

In her letter to DME suppliers, DeParle notes that HCFA will focus on measuring and identifying payment errors per contractor under the Comprehensive Error Rate Testing (CERT) Program, which began July 1 with the four regional equipment carriers. (For more information on CERT, see "Updata" in the July 2000 HEALTHCARE FINANCIAL MANAGEMENT.)

DeParle informed home health agencies that HCFA will focus on these agencies' two most common errors: failure to document the need for daily skilled nursing visits beyond 21 days and failure to obtain dated physician certification before billing for home health services.