New Claims Review Process for Hospice 7/25/12
The state of Idaho is instituting additional claims review processes for all Medicaid participant's receiving hospice services. To ensure compliance with hospice program regulations, claims will be "pended" and undergo medical review. This review will determine if the hospice provider is financially responsible due to the claim being related to the participant's terminal illness, or if Medicaid is responsible if the claim is not related to the terminal illness. Claims from non-hospice providers and hospice providers will be included in the ongoing review. There may be some delay in the processing of these claims.