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By Kaitlyn Mattson | October 7, 2018 The home health industry has won another victory in Washington, D.C., in its battle against certain parts of the Patient-Driven Groupings Model (PDGM) and shift toward a more pre-acute care identity. Sens. Susan Collins (R-Maine), Bill Nelson (D-Fla.) and Debbie Stabenow (D-Mich.) introduced the Home Health Payment Innovation...
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To combat improper billing, the Centers for Medicare & Medicaid Services (CMS) in 2016 rolled out the controversial pre-claim review demonstration in Illinois, an initiative that required home health providers to send in their claims earlier in the care process. With the help of Congress, however, stakeholders were able to seemingly stop pre-claim review dead...
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Failing to supply medical records in response to additional documentation requests (ADRs) was Medicare Administrative Contractor (MAC) Palmetto GBA’s most common reason for denial of home health claims between April and June 2018, Palmetto data show. Face-to-face encounter requirements not met took the No. 2 slot. Denial code 56900 (Auto denial — requested records not...
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Healthcare is one of the biggest industries in the world, home healthcare being just one sub-category of that industry. Diagnosing and treating patients has always been the focus of the business of healthcare. To achieve success requires a balance of resources and manpower so that quality patient care can be provided. When it comes to...
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Managers and supervisors generally take on the role of “many hats”.  Many managers have to manage clinical staff daily and are responsible for scheduling, compliance, administrative and operational duties. Often managers are also responsible for quality programs and practices along with these other duties. It’s not hard to be consumed by one of these responsibilities...
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Outsourcing consultants can analyze data for accuracy and determine that proper plans of care are initiated for patients. Accurate plans of care ensure that relevant treatments and goals are captured and promote opportunities to improve quality measures. Accurate data collection also identifies true areas for improvement to support performance improvement and QAPI programs. Outsourcing consultants...
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