PCR Resubmissions

When utilizing the Pre-Claim Review (PCR) resubmission process, most of the fields are editable. There are however, a few fields that must match the initial request in order to determine if the resubmission is a true resubmission, or if the request is for a different beneficiary, home health agency (HHA), and/or period of time. Additionally, to help save time, many fields are auto-populated. Fields that are auto-populated may or may not be available for editing during the resubmission process. Fields that are not able to be edited during the resubmission process include:

• Beneficiary first name
• Beneficiary last name
• Beneficiary DOB
• PCR billing period start date
• PCR billing period end date

The most common question we receive for the resubmission process is regarding the ability to edit the billing period “Start” and “End” dates. These fields are not editable to ensure a submitter does not compromise the process. Consistency in these five fields ensures that the resubmission is actually a resubmission and not an initial submission for a different beneficiary or billing period.

Please ensure that the dates are accurate when submitting a PCR request. If the dates were incorrect on the initial submission, the resubmission process cannot be utilized, and a new initial submission is required.