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Saturday, March 11, 2017

LUPA

• Standardized per visit payment made in lieu of HH PPS payment
– Applied to claims with four or less visits in the entire episode 
– Per-visit rates published in HH PPS rate update calendar year final rule

No-RAP LUPA
• Advance knowledge of LUPA for episode 
• HHA chooses to not submit RAP 
• Claim may be adjusted later if visits are added that exceed LUPA threshold 
– Remember to submit RAP before adjusting claim

National Government Services Web Resources
• Top Claims Submission Errors 
• Home Health Job Aids 
• FISS/DDE Provider Online Manual 
• Training Events Calendar 
• Education Session Material 
• E-mail Updates 
– New Medicare information (billing and coverage)
– Provider education and training announcements

Top Claims Submission Errors
• Includes the top error codes and helpful hints on how to resolve the top errors 
– Select Go to Home Page link for appropriate Medicare contract/state combination from start page 
– Select Accept on the HCPCS/CPT attestation page 
– Select Top Claims Submission Errors subnavigation under Claims 
– Reason code reports are listed by workload and type

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