On Tuesday, July 25, 2017, CMS issued the CY2018 Home Health Proposed Rule. Effective for home health episodes of care ending on or after January 1, 2018, the rule updates the Home Health Prospective Payment Systems (HH PPS) payment rates including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor. […]Continue Reading
Widespread EHR use in the health care sector comes with new challenges in terms of data entry and management. As EHR technologies and processes have evolved, many organizations have run into a situation where varied policies and procedures surrounding data entry has led to major quality issues. Poor data quality undermines an agency’s ability to use data to support patient care, […]Continue Reading
Home health claim denials can cause a number of problems for agencies of any size, with cash flow being the biggest concern. Home health agencies should have plans in place to avoid denials, as well as plans on how to handle them when they occur. By having advance knowledge of the potential red flags that may come up at your agency, […]Continue Reading
Home health regulatory requirements create a variety of documentation and management challenges that home health agencies must be prepared to address. In particular, emerging regulatory changes surrounding Medicare home health fraud are pressuring agencies to keep an especially close watch over every facet of operations.
According to a CMS Comprehensive Error Rate Testing (CERT) report released last year, […]
We are pleased to announce the release of a new white paper that takes a look at the current home health regulatory environment and the efforts to crack down on home health fraud by the federal government.
The white paper, “Home Health Regulatory Pressures Rising as Government Ramps Up Fraud Prevention” discusses the environment beneath regulatory pressures including the risks of fraudulent activities, […]
Comprehensive home health documentation is necessary to ensure both quality patient care and proper reimbursement. Stronger focus on investigating what CMS deems as fraudulent activity combined with efforts to ensure more accurate reimbursement means that home health agencies must take steps to ensure documentation integrity. Tina Marrelli, MSN, MA, RN, FAAN, President of Marrelli and Associates and author of The Handbook of Home Health Standards offers some great information about the importance of home health documentation and problems to avoid. […]Continue Reading
Recently there has been a lot of talk about cyberattacks on healthcare organizations around the world. While attacks like this are uncommon, it reminds us that maintaining security of devices, systems, and networks is of utmost importance to reduce your home health & hospice security risk.
Here are five tips to follow to reduce your security risk and keep your sensitive data secure:
Conduct a risk analysis: The HIPAA Security Rule requires covered entities to maintain reasonable and appropriate administrative, […]Continue Reading
What is PECOS?
Created by CMS, PECOS stands for Provider, Enrollment, Chain and Ownership System and is a database for physicians who have registered with CMS. The Affordable Care Act requires physicians and other eligible non-physician practitioners (NPPs) to enroll in the Medicare Program to order/refer items or services for Medicare beneficiaries. Medicare will deny claims for services or supplies that require an order/referring provider to be identified, […]
Home Health Compare is a joint effort between the Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Health and Human Services (DHHS). It provides data on the quality of services provided by Medicare-certified home health agencies mostly through Outcome and Assessment Information Set (OASIS) data submitted to CMS.
OASIS is the instrument and data collection tool used to collect and report home health agency performance data through:
Other internal agency-level applications
Home health agencies can use Home Health Compare reports to identify how well they are doing compared to other agencies. […]Continue Reading
Springfield, Mo. – March 7, 2017 – HEALTHCAREfirst, the leading provider of Web-based home health and hospice software, billing and coding services, and advanced analytics, announced its partnership with PDC, an independently owned pharmacy benefit manager built purposefully for hospice, to improve the management of patient prescriptions.
This interface provides automatic transfer of demographic data from firstHOSPICE to the PDC software. […]