Home Health Line
02/03/2014
Scrutinize claims involving episodes with 20 or more therapy visits to prevent denials when Medicare Administrative Contractor (MAC) Palmetto GBA performs its latest medical review edits.
 
02/03/2014
 Make sure you understand that an adaptive reader — usually software or other electronic devices designed to magnify text and help people see better — is not what CMS has in mind when it defines “corrective lenses” as you answer M1200 (Vision).
 
02/03/2014
A First Amendment case currently before the Supreme Court could affect a union’s ability, or even its inclination, to conduct collective bargaining negotiations for a substantial number of home care workers in Illinois.
02/03/2014
Consider buying clinicians cleats or other winter gear to protect them from extreme cold and heavy snow that has enveloped much of the United States this winter.
02/03/2014
Palmetto GBA is performing its latest medical review edits on cases involving HIPPS codes 5CHK*, 5CGK* and 5BHK* (last digit variable). These codes involve episodes with 20 or more therapy visits. 
01/27/2014
The number of home health agency/hospice requests for appeals hearings before administrative law judges (ALJ) over claims denials rose significantly last year from 11,677 in 2012 to 26,710 in 2013, the Office of Medicare Hearings and Appeals (OMHA) reports.
 
 
01/27/2014
Each face-to-face form must now include two sets of criteria that CMS added to the definition of homebound status last October, CMS announced in a Jan. 14 MLN Matters article. The narratives that physicians’ offices provide must also include as much patient-specific information as possible to prove the patient is homebound. Simply listing diagnoses, recent injuries or procedures is not sufficient to make this case; nor is vague language such as “gait abnormality” or “generalized weakness,” CMS says.
 
 
01/27/2014
Educate referral sources about the increased level of specificity they’ll need to provide to minimize productivity loss and prevent denials in the future.
 
 
01/27/2014
Agencies can get the level of specificity they need by revising their intake processes.
 
 
01/27/2014
As more nursing graduates with little home health experience enter the field eager to work, make sure your agency has a detailed, well-structured nursing orientation plan in place, as it can pay dividends in employee satisfaction, retention and, eventually, productivity and outcomes.
 
 

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