Palmetto GBA has identified that some hospices are receiving late filing appeal submission dismissal letters after filing an appeal for an untimely Notice of Election (NOE). These letters state that Palmetto GBA is unable to process your claims due to “Our records indicate you have the ability to enter/adjust claims in DDE and/or EMC…” or “Other reason: Invalid use of Redetermination Form. Contact the PCC for assistance.”
At this time, no provider action is necessary. Palmetto GBA is reprocessing these requests and, once the review is complete, will adjust the claim appropriately.
Palmetto GBA explains the impact on providers:
Palmetto GBA has determined these response letters may have been issued in error when a claim was previously received requesting a late NOE filing exception.
Please note the initial claim submission is required to follow the directions outlined in the ‘Hospice Billing When a Notice of Election (NOE) was Filed Untimely Job Aid.’ Therefore, an Occurrence Span Code (OSC) of 77 with dates, the KX modifier and remarks are entered on the claim. If the exception was not submitted using the above direction, please adjust or resubmit your claim appropriately.
Learn more on Palmetto GBA’s website here.