What requirements must be met before sending a RAP/NOA?


RAPs/NOAs On and After 2021

I. have a valid verbal order that specifies the skill and services to be provided during the initial visit

II. have completed the initial SOC visit (in Barnestorm, the visit must be started).

NOTE:  If the chart/episode does not show up for NOA, verify the following:

a.  Check the referral to make sure the Start of Care date matches the SOC visit date.

b.  Check the referral to make sure the correct payer source is listed.

Prior to 2021

RAP = A Request for Anticipated Payment.
This request is sent at the beginning of an episode in order to maintain a reasonable cash flow. A RAP is not a true "claim", because there are no charges on it - only the HIPPS code and the date of the first visit made during that episode.

Four conditions must be met before a RAP claim can be sent:

Physician's orders have been received and documented

The first billable visit has been delivered and charged to that PPS payer

OASIS is complete, locked or export ready

Plan of Care has been established and sent to physician for signature

For additional information on Submission of Request for Anticipated Payment (RAP), please view the following link Medicare Claims Processing Manual, Chapter 10, Section 10.1.10.3.

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