Reason Code: U5166

Error Description:

Hospice: Hospice claim received and the ‘From’ date falls within an established hospice election period and the start “2” date is equal to zeros (no change of ownership or provider change has occurred). The provider number on this claim is not equal to provider “1” on established hospice election period.

Avoiding/Correcting This Error

• If a transfer occurred, verify that all claims and notices are submitted in order. The transferring-from hospice agency needs to submit their final claim prior to the transferring-to hospice agency submitting their notice of change/transfer (TOB 8XC).
• If a change of ownership has occurred, verify that the notice of change of ownership (TOB 8XE) is submitted and finalized prior to submitting claims under the new provider number.
• Check HIQA to see how the elections are presently posted. Correct the appropriate NOEs or claims and then resubmit this claim.