Transfer

• Transfers happen when a beneficiary changes from one HHA to another within a 60-day episode

• Responsibilities for receiving HHA and transferring HHA:

 – Receiving agency: 

1.  Checks beneficiary eligibility for home health care; verifies services not already provided by another HHA 
2.  Informs beneficiary
3.  Coordinates with initial HHA 
4.  Submits properly coded RAP 

– Transferring agency submits properly coded discharge claim

Transfer Process

• Inform beneficiary

– No further services from the initial HHA

– No further payments received by initial HHA 

– You are now primary HHA responsible for all services outlined in the plan of care 

• Document beneficiary was notified of transfer process

• Receiving agency coordinates with initial HHA

– Contact and coordinate transfer date 

– Document communications between agencies 

– Submits RAP indicating transfer (condition code 47)

 • Transferring agency submits discharge claim showing transfer status ’06’ 

– this claim will receive a PEP adjustment due to the shortened episode

Discharge & Readmission

• Patient discharged before end of 60-day episode 

• Same agency readmits in the same 60 days – Pro-rated first episode – New 60-day clock 

• This scenario MUST be billed with a shortened first episode (PEP adjusted claim with patient status code ’06’) and a new RAP that shows the readmission