As of January 1, 2011, Medicare Advantage PPO host claims submitted as Request for Payment, or RAP, claims for home health services are no longer accepted from participating providers. Participating home health providers should submit host claims for services using the same procedure they use for local claims. Please refer to Section 9.10: Billing and Reimbursement for Ancillary Services of the Hospital Manual for Participating Hospitals, Ancillary Facilities, and Ancillary Providers, for instructions on how to submit a claim for home health services.
The Hospital Manual is available on the NaviNet® web portal under the Current Publications section. If you do not have access to NaviNet, you can submit an online request at www.ibx.com/providersupplyline or call the Provider Supply Line at 1-800-858-4728 to request a printed copy.