Why billing after death is complicated

Death is inevitable. However, the administrative aspects of dying — billing for appropriate services after the date of death, trying to correct an incorrect date of death or trying to prove that claims of one's death were premature — can be more complicated than people realize, said Ronald Hirsch, MD, vice president of the Regulations and Education Group at Accretive Health's Accretive Physician Advisory Services.

Dr. Hirsch recently made this statement while discussing the topic in an RAC Monitor report.

Below are two examples he offered of the complications involved after death.

  • Dr. Hirsch recalled an incident in which a hospitalized patient improved and was discharged with home health services. He said in the report that the home care agency initiated a plan of care. The patient died a week later. When he submitted a claim, indicating the date of service as the date that he reviewed and signed a copy of the plan of care for that patient, it was denied, along with a notation that the patient was dead on that date of service, the physician said. "It is true, but billing rules required that I billed with the date I actually reviewed and signed the form, not the date on which the care plan was developed," he wrote.
  • Dr. Hirsch also referenced a similar dilemma in which an unnamed hospital indicated they had difficulty with their Medicare Administrative Contractor. He said in the report that the hospital had processed a claim associated with a patient who died at their facility, but the funeral home listed an incorrect date of death on the death certificate. The claim was denied because the hospital did not have the correct information. "The funeral home corrected the death certificate, the MAC updated its system and the Social Security office updated. But the claim is still not being approved for payment because the Medicare common working file had not been updated. According to the MAC and the Social Security office, this can only be done via a family member requesting the correction," Dr. Hirsch wrote.

 

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