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Loving Hearts Home Care Case Study

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This letter serves as a written notice of Loving Hearts Home Healthcare Inc. appeal to the overpayment amount of $5,034.90, which was identified in the overpayment notification letter. Specifically, those claims billed for Marjorie Savage that have been labeled with a discrepancy code 911. The notification letter provided the following explanation for the discrepancy code, which resulted in an overpayment: • Documentation in the employee personal file indicated that the provider failed to obtain criminal record clearance for the employee in accordance with the Code of Virginia 32.1-162.9:1. 12VAC30-120-930, 12VAC30-120-950 AND 12VAC30-120-960 state, “Providers are responsible for complying with §32.1-162.9:1 of the Code of Virginia regarding …show more content…

made every reasonable attempt to receive the criminal background checks in a timely manner. Loving Hearts Home Healthcare Inc. remained in constant and consistent contact with the Virginia State Police Staff, checking and maintaining the status of the criminal records. Loving Hearts Home Healthcare Inc. consistently received responses of “severe backlog” from the Virginia State Police. While making every reasonable attempt to receive the criminal records in a timely manner; Loving Hearts Home Healthcare Inc. cannot control how quickly the Virginia State Police conducts background checks, nor should the agency be held liable for the backlog that the Virginia State Police had at the time. Further, Loving Hearts Home Healthcare Inc. acted within its maximum capacity and abilities to maintain the criminal backgrounds checks by making every reasonable attempt to stay in constant communication with the Virginia State Police in an effort to be in compliance with §32.1-162.9:1 of the Code of Virginia and requirements of the Department of Medical Services. The record of communication with the Virginia State Police was included in the initial agency response and has been included in this Appeal for your

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