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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. Since home health and hospice providers may have vast amounts of payers or locations, a payer matrix will be a vital tool for centrally storing information on obtaining insurance verifications, authorizations, billing guidelines, follow-up techniques, and reimbursement rates.
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. 
23 August 2018 - 8:13, by , in Blog, Post Acute, Comments off
OASIS Background As described by CMS, the Outcome and Assessment Information Set (OASIS) “is a group of standard data elements….designed to enable systematic comparative measurement of home health care patient outcomes at two points in time. OASIS-based quality measures can be used for quality improvement efforts that home health agencies (HHAs) can employ to assess...
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. 
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.
Medicare Beneficiary Identifiers
26 April 2018 - 13:16, by , in Blog, Post Acute, Comments off
April of 2018 marks the beginning of Medicare’s transition to the new Medicare Beneficiary Identifier (MBI) which is slated to replace the current Health Insurance Claim Number (HICN) as the primary identifier for its beneficiaries.
Episode Management
27 February 2018 - 16:16, by , in Blog, Post Acute, Comments off
Explore findings from past and present episode management engagements and discuss episode management’s role in improving clinical and financial outcomes and raising patient satisfaction scores. Findings suggest that a strong episode management program promotes patient-centered care and includes ongoing communication throughout the continuum to aid in care coordination, OASIS accuracy and ensure patient satisfaction.
Conditions of Participation
12 January 2018 - 21:01, by , in Blog, Post Acute, Comments off
With a successful system conversion, providers can look forward to reduced write-offs, increased cash flow, better revenue recognition, detailed data metrics and more insight on day-to-day operations. In order to yield long term benefits of a system conversion, it’s crucial to find a right fit for your organization as well as assess cultural readiness and process changes.