What is an NOA? Key Insights for Home Health Providers

May 21, 2024

In 2021, the home healthcare industry underwent a significant shift with the transition to a no-pay Request for Anticipated Payment (RAP). This move was a preparatory step towards completely phasing out the RAP and replacing it with the Notice of Admission (NOA) in 2022, as part of the final phase of the Patient-Driven Groupings Model (PDGM).

What is an NOA?

An NOA is a one-time submission required to establish the home health plan of care (POC) and it covers consecutive 30-day POC intervals until the patient is discharged. The NOA must be submitted within the first five days following the admission of care, using Type of Bill (TOB) 32A for the initial submission and TOB 329 for the POC. Any delay in submission incurs a daily penalty, which is 1/30th of the total reimbursement for each day the NOA is late.

Purpose of the NOA

The NOA serves as a formal notification that the submitting organization will provide patient care, and it remains valid until the patient is discharged. Organizations are required to submit a new NOA for any claims made after a patient is discharged and subsequently readmitted.

Payers and NOA

Although Medicare mandates the submission of an NOA, it is advisable as a best practice for healthcare organizations to submit NOAs for all patients. Medicare Advantage (MA) plans have differing requirements regarding NOAs, so it is crucial for healthcare providers to verify the specific needs of each MA contractor.

Existing Patients and the NOA Requirement

For all existing patients whose home healthcare services continue into 2022, an NOA is required. In such cases, an NOA with an artificial "admission" date that matches the "from" date of the first payment period in 2022 needs to be submitted.

Tools and Software

Utilizing advanced home health software solutions, such as Axxess Home Health, can facilitate the transition to NOAs by automatically updating workflows in line with the required go-live dates. Intelligent, cloud-based software can help protect revenue and ensure compliance throughout this transition.

Key Takeaways for Home Health Organizations

Home health organizations must grasp and prepare for the changes in the billing process by becoming proficient with NOA submissions. Timeliness in submitting NOAs is critical to avoid financial penalties. It is also important to stay informed about the requirements of Medicare Advantage plans regarding NOAs and maintain open communication with contractors. Leveraging advanced home health software can aid in a smoother transition and minimize the risk of financial and operational disruptions.

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