Medforce Blog

Home Health Pre-Claim Review Pilot

October 27, 2016

Category: News

The demonstration project for the new pre-claim review required by CMS is underway in two states and is going to be rolled out to three more in the near future. Medforce is working hard to help our Home Health clients to address this major change in two ways:

Process evolution

We are assisting in the reworking of processes to account for the earlier submission of documentation. We are currently helping customers to implement CommandCenter address and overcome the new administrative and compliance workflow challenges imposed by the pre-claim review demonstration project. 

Electronic documentation submission

ZipMit can now be used to transmit Home Health pre-claim reviews to the pilot areas as they become active.  Currently only MAC JM (formerly J11) – Palmetto is now accepting HH pre-claim reviews via ZipMit for Illinois and Florida.

Here are the initial state activation dates:

  • Illinois - August 1, 2016
  • Florida - October 1, 2016
  • Texas - December 1, 2016
  • Michigan - January 1, 2017
  • Massachusetts - January 1, 2017

For more information about how Medforce can help you address this new requirement, please contact us by filling in the form below or emailing us at




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