Learn key discharge planning strategies for effectively managing patient care while meeting the varying LUPA thresholds within each of the two 30-day PDGM payment periods.
Learn the common trends that result in a subsequent 30-day period LUPA, discuss EMR strategies to help effectively manage LUPA billing periods for maximized financial outcomes and determine best practices in developing an effective plan of care to improve patient outcomes.
It’s apparent that home health providers are struggling with efficient visit utilization under PDGM. By leveraging best practice episode management strategies, however, providers can drive efficient visit utilization, deliver high quality care and ensure financial viability.
Clinical documentation plays many roles within healthcare. It validates the patient care provided, supports coding decisions, and facilitates claims processing, billing, and reimbursement. But at its core, clinical documentation works as a narrative in telling the patient’s story – where the patient has been, what they are going through and what the future holds for them.
Questionable Encounters are primary diagnosis codes that are not specific enough to support the need for home health services that result in a return to provider (RTP) and ultimately delays in payment.
CMS issued the CY 2020 Home Health Prospective Payment System Rate Update, which finalized changes for the Patient-Driven Groupings Model (PDGM) that will go into effect on January 1, 2020.
As the Patient-Driven Groupings Model (PDGM) is approaching, organizations are currently focusing on how it will impact revenue cycle functions. To prepare financially prior to PDGM’s implementation date of January 1, 2020, home health organizations can focus on cash collections to be prepared for any loss or delay in cash flow due to the significant changes under the new model and identify risks that could cause potential delays across the revenue cycle.