Be proactive about surviving the PDGM transition with intake preparation guidelines designed to maximize revenue and enhance accuracy

Stressed about billing and revenue issues after PDGM implementation? All you need to know is that it all starts with intake.

The intake process is the start of care, and if done with purpose, can set your organization up for optimum efficiency. Simply put: quality and accuracy up front will be critical in preventing downstream issues with billing and revenue. The key to PDGM preparedness is intake – and these are a few ways you can start transforming your process.

1. Understand diagnosis coding

Planning for changes to your referral and intake processes before PDGM implementation includes developing scripts for intake staff. This will give them a better understanding of diagnosis coding requirements and will make those calls to referral sources much easier when it comes to ensuring all necessary documentation is received at the point of intake.

2. Be able to accurately identify the details

If you don’t already, you need a system in place that can identify:

• Community versus institutional admission sources

• Early timing versus late timing

• Home health primary diagnosis and comorbidities

• All supporting clinical documentation is received

PDGM demands accuracy, and these details ensure you’re on the right path to a process that can achieve that.

3. Take control of the inpatient facility and discharge date

Develop a process to assure M1000 (Inpatient Facility) and M1005 (Discharge Date) are answered correctly, involving intake to confirm inpatient facility discharge dates within the 14 days prior to admission to home health. Seek discharge summaries as supporting documentation and look for opportunities in your EMR to populate the admission source and discharge date to M1000 and M1005. You should also consider having your process populate the admission source information to these OASIS questions as well.

By taking control and ensuring these questions are answered accurately, you’re just one step closer to maximizing your revenue.

Time is running out – stop stressing about PDGM

You must have a deep understanding of how PDGM works and how it will affect reimbursement to successfully prepare well in advance of the change. We can help. Download our guide to learn what PDGM is, the key changes included in this payment model that could significantly impact your organization, and how you should start preparing today.

Developing a well-structured process now will lead you to PDGM success.