F2F Denials Begin
We learned this week that several members are receiving denials of Medicare claims with the explanation, "Need Face to Face Encounter Certification Signed by the Same Physician who is Certifying the Plan of Care" (denial code # 55HTB). Margaret Franckhauser of Central NH VNA & Hospice reported the issue to VNAA, who shared the situation with CMS Administrator Jonathan Blum yesterday (June 29) during a meeting on face-to-face encounter documentation.
VNAA policy director Kathleen Sheehan reports that Blum responded with a commitment to address the concerns. He enlisted Carol Blackford, Deputy Director of CMS' Chronic Care Policy Group, to research the issue. We'll see what action CMS takes, and when, to correct this problem.
In the meantime, agencies that receive what they believe are improper denials based on the F2F documentation should continue to request reviews and, if necessary, appeal the denials.