With HEALTHCAREfirst, one agency found more than just coding clarity

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PDGM Case StudyWhen Addison County Home Care & Hospice went in search of outsourced coding, they ended up with an expert level solution for not just coding – but also PDGM prep, OASIS, and customer service that is second to none.

“The breadth and depth of the coding that we needed to sustain ourselves, and also with the highlights of PDGM coming, was just…not viable.”, Deb Wesley RN, BN, MSN, MHA, CEO/VP of Clinical Services at Addison County Home Health & Hospice

Deb Wesley, CEO and Vice President of Clinical Services at Addison County Home Health & Hospice, had one challenge: coding. Addison was growing, and of all the things they were taking on, Wesley knew they would not be able to self-sustain while handling the coding in-house. OASIS? They could learn that. But coding needed to be outsourced so that more time could be dedicated to patients.

Not really knowing what they needed, she began touching base with several agencies, testing vendors against one another. Only one of these vendors had a grasp on coding that went well beyond the others – HEALTHCAREfirst. They understood that the importance of coding wasn’t just accuracy and compliance, but that it also removed the obstacle between Addison and its patients. To this day, Addison works one-on-one with the same team that worked through their initial testing. And Addison soon learned that HEALTHCAREfirst would streamline much more than their coding processes.

Solution

When Wesley was in the testing process of finding a new vendor, she went beyond just sending them information straight from Addison’s EMR. “I deleted diagnoses, I gave them half the
information. I wasn’t pleasant,” says Wesley. “I gave them a job, and I tested them against two other places, and they came out heads and tails ahead.” HEALTHCAREfirst left an amazing impression and it won them Addison’s business.

When it came time to onboard HEALTHCAREfirst, their familiarity with Brightree simplified the whole experience. Wesley says, “it’s not a company we had to train and teach what was in our system. They knew how to get there, they knew how to navigate Brightree, they knew everything in it.” But what really set HEALTHCAREfirst apart during the onboarding process, was that they did what many vendors fail to do: they listened. Addison knew what worked for their workflows, and HEALTHCAREfirst accommodated their patterns to make sure those processes were not interrupted. “They didn’t dictate here’s what we do. They asked us what we need,” says Wesley. “They’ve been very
responsive to our system and our process.”

Once HEALTHCAREfirst was up and running with Addison, they left no code unturned. “These people,” Wesley jokes, “if I didn’t know their names and haven’t spoken to them, I’d swear they’re machines. They are impressive.”

Because product integrity is important to Addison, HEALTHCAREfirst audits 100% of their records in home health. “Every record, regardless of payer, looks the same,” says Wesley. “I want every record scrutinized, reviewed, and audited the same.”

It’s that personal touch, the relationships, that make HEALTHCAREfirst different from any other vendor on the market. “If I have a problem,” says Wesley, “I call my contact, he responds right back, and it’s taken care of.”

Wesley has heard others in the industry talking about their vendor experiences. “Others were saying they’re not satisfied with their vendor right now because they’re shipping it overseas,” Wesley explains. “They’re not getting the personal touch.”

Results

With HEALTHCAREfirst’s attention to detail, and their consistent team of experts working in tandem with staff, Addison has been able to streamline their processes and generate a variety of codes for every patient. “They really, truly scrutinize that record, and come up with every appropriate code,” says Wesley. “Which, coming into PDGM, is even more important.”

While preparing for PDGM wasn’t their number one need when searching for a vendor, Addison has discovered the true value that HEALTHCAREfirst has provided – PDGM stress relief. “The one thing we don’t have to worry about in PDGM is the coding,” says Wesley. “I got that hands down – now I can focus on everything else.”

Addison staff are busy looking at care plans, interdisciplinary collaboration, streamlining the visits, and the visit spreads.Everybody else is trying to figure out how to code it in the right priority, and that’s not even on Wesley’s radar. “That’s done. Been done. And taken care of.”

With more streamlined processes and the time to focus on tasks beyond coding, Addison began to notice the integrity of their clinical record. “I can’t even speak to how much more it’s improved,” says Wesley. “But the most significant growth we’ve seen since starting with HEALTHCAREfirst is the integrity of the product itself.” This is because the diagnoses are actually reflecting the patients’ conditions. Whereas before HEALTHCAREfirst, they would get obscure, poor coding.

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