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16 January 2019 - 17:36, by , in Post Acute, Comments off
The Patient-Driven Groupings Model (PDGM), is the most significant change to the home health payment reform in the past 20 years. PDGM completely alters the methodology for calculating payments, and an example of this is the removal of therapy utilization as a component and the payment periods have been reduced from 60 to 30-days. In addition to the many clinical and overall operational modifications that will be required, these noteworthy changes in computing Medicare payment rates could also profoundly impact a provider’s PDGM reimbursement levels in comparison to historical PPS payment levels...
15 January 2019 - 13:54, by , in Blog, Post Acute, Comments off
A well thought out payer matrix can become the central knowledge base of any revenue cycle department. It’s a resource that will serve many operational purposes and ensure that organizational knowledge is well distributed without being lost.
cash flow maintenance
19 December 2018 - 10:52, by , in Blog, Post Acute, Comments off
Cash flow maintenance is paramount to sustaining any health care provider, especially through this era of rapid policy change and regulation. Organizations attempting to go through transitional phases such as process realignment and systems implementation are especially susceptible to reduced cash flow, both during and following these transitions...
Process Wheel
26 October 2018 - 14:12, by , in Blog, Post Acute, Comments off
A well thought out payer matrix can become the central knowledge base of any revenue cycle department. It’s a resource that will serve many operational purposes and ensure that organizational knowledge is well distributed without being lost.
Sequelae
17 September 2018 - 13:46, by , in Blog, Post Acute, Comments off
A common question asked among coders is, “is this a complication or is this a sequela”?  Following specific coding guidelines will ensure that costly errors are avoided for these two very different coding situations. 
Comprehensive Internal Audit
23 August 2018 - 8:13, by , in Blog, Post Acute, Comments off
OASIS-D is the latest data set for home health agencies to utilize and will be effective January 1, 2019. The focus of this latest revision is on quality and comparison of those quality indicators.
Magnifying Glass
25 July 2018 - 10:13, by , in Blog, Post Acute, Comments off
At the end of May 2018, CMS released a notice to providers describing their intention to implement an updated version of the previously paused Pre-Claim Review Demonstration. The revision is titled “Review Choice Demonstration for Home Health Services (RCD). Providers in the RCD states should not wait to act.
Magnifying Glass
12 July 2018 - 9:01, by , in Blog, Post Acute, Comments off
The proposed home health groupings model (HHGM) has resurfaced in an updated form—the Patient-Driven Groupings Model (PDGM).
Episode Management
29 June 2018 - 15:43, by , in Blog, Post Acute, Comments off
The new Conditions of Participation (CoPs) incorporate a focus on patient-centered care. A growing concept within the health care industry over the past several year, patient-centered is defined as “providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.”  Effective episode management is critical to all home health agency’s success in incorporating patient-centered care strategies to increase compliance with these new conditions. 
PEPPER
20 June 2018 - 10:36, by , in Blog, Post Acute, Comments off
You should check out your Home Health Agency’s (HHA) annual Program for Evaluating Payment Patterns Electronic Report (PEPPER). Why? This underutilized report uncovers risk areas in billing processes, provides insight into episode utilization, and compares your agency’s data to others in the market.