Home Health Line
01/26/2017
Revise the job responsibility of your agency’s clinical manager to ensure she proactively discusses patient outcomes and reviews documentation including the plan of care of each patient with the case manager.
01/26/2017
by: CMS
G0158 (Written plan of care established and periodically reviewed) remained the most common standard-level deficiency in 2016, followed by G0159 (Plan of care covers diagnoses, required services, visits, etc.), data CMS provided HHL show.
01/20/2017
by: CMS
CMS estimates the cost for the revised CoPs in year one is more than $293 million, while the estimated cost in subsequent years is $290 million.
01/17/2017
Illinois home care nurses and home health agencies faced a challenging year in 2016, to put it mildly. They have risen to the challenge of Pre-Claim Review (PCR) with tenacity and ingenuity, as they have to the many past changes and hurdles to arise in our industry. And as always, they’ve put their patients first.
01/16/2017
Billing staff for home health agencies nationwide should become familiar with their Program for Evaluating Payment Patterns Electronic Report (PEPPER) and review it annually. These free reports identify potential patterns that may indicate improper billing involving traditional Medicare.
01/09/2017
Mrs. Smith came home last night from rehab after having an exacerbation of her coronary artery disease and suffering an acute NSTEMI three weeks ago.  You are doing the start-of-care (SOC) assessment today. The discharge paperwork from the rehab indicates the patient’s height is 5 feet, 6 ½ inches and her weight on the day of discharge home was 155.2 pounds. How should you answer M1060 (Height and weight)?
01/01/2017
Examine how frequently the primary diagnoses you list will be deemed “questionable encounter” codes under the Home Health Groupings Model (HHGM). As needed, train staff to query physicians for more specific information so you can avoid red flags for auditors today that will lead to claims being bounced back under the HHGM
01/01/2017
Restructure clinical managers’ positions so they function more like case managers. Doing so will help you prepare for care planning and coordination changes that are a part of the revised Home Health Conditions of Participation (CoPs).
01/01/2017
While it’s an understandably attractive practice to pay RNs and therapists the same lump sum for each patient visit, it’s not in your agency’s best interest to pay per visit unless you are also willing to pay overtime.
12/29/2016
Conquer the confusion that surrounds the coding of common pulmonary conditions, including chronic obstructive pulmonary disease (COPD), to ensure your coding is accurate and sufficiently captures the care your agency is providing.

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