Good Morning MFS Hoem Health Bloggers,
The RHHI recently posted an article on RAPs as they were noticing various errors within their system when receiving RAP from providers throughout the country.
Per the RHHI, RAP’s will cancel as they normally do when any final claim posts to the Common Working File (CWF) or when the final claim is not received on time from the home health agency (i.e., within 60 days of the date the RAP was processed or 120 days from the start date of the episode).
Home Health Agencies often mistakenly resubmit RAPs because they do not receive payment on the RAP and believe that the RAP was not posted to CWF. The RAP does exist, so the RHHI requests that home health agencies do not resubmit another RAP unless the RAP auto-canceled because the final claim was not submitted on time. When the RAP is processed, it will go into a “P” status, but does not receive payment and receives a “Z” no pay code because of an open MSP record. The home health agency should not send a request for the RAP to be cancelled or adjusted. The home health agency provider should submit the final claim with the correct information and/or MSP codes. If the final claim was previously submitted and has been rejected (R status), check to see if it has posted to the CWF. If so, then the home health agency provider must submit an adjustment request once they have received payment from the primary insurer, a denial or have information documenting Medicare is primary.
Have a great week!!!! Chris
