To Medicare Home Health and Hospice Clients:

Continuation of Sequestration Suspension
The CARES Act temporarily suspended the 2% sequestration payment adjustment currently applied to all Medicare Fee-For-Service (FFS) claims through December 31, 2020. The suspension has now been extended through March 31, 2021.  The Sequestration Rates FAQ has step-by-step instructions on updating rates for Medicare Hospice and Medicare and Medicare Advantage PDGM payers.

Unverified Visits from Clinical
To assist with PDGM Home Health billing in 2021, myUnity Essentials Clinical will begin sending unverified visits to Billing in order to receive the first billable visit to allow the SOC RAP to bill out within 5 days after the admit date.  If your agency previously opted out of this functionality, it has now been turned back on. For non-PPS billing, billers can turn off the flag to not fail for unverified visits via the More Options tab of the Billing Pre-Audit Report.

To Medicare Home Health Clients:

Medicare Advantage Payers 
If you haven't done so already, contact your Medicare Advantage payers to determine their billing requirements for 2021.  No changes will be needed for payers following Medicare billing rules.  If you bill any Medicare Advantage plans that have different claim requirements in 2021, kindly submit that information in writing to myUnity Essentials Financial Support via the support portal at https://netsmartcares.force.com.

Days to Rap Setting

Now is the time to update your agency's Days to RAP setting in File > File Maintenance > System Settings on the Reporting tab to allow billing the second period within a cert prior to the period start date. Enter a value up to  -29 to allow the Period 2 RAP to post as early as day 2 of the 60-day certification period.


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