News & Articles

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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To our IAHHC Membership, our friends in the industry need our help! Please see the email below which is forwarded from Tim Rogers, President and CEO of the Association for Home and Hospice Care of North Carolina. Please help as you are able. Cindi Wessel, Home Health and Hospice Resource Director, IAHHC www.ahhcnc.org/florence We want...
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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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The Proposed New National Standardized 60-Day Episodes Rates are listed below: Proposed National Standardized Episode Rate $3,151.22 Proposed Rate (Did Not Submit Quality Data) $3,089.49 Remember your individual agency rate will be adjusted by wage index. If your patients live in a rural area you will receive an additional payment. We will go over the...
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The Centers for Medicare & Medicaid Services (CMS) is proposing to overhaul the home health prospective payment system and continue the shift toward value-based care. Specifically, the agency is moving forward with the Patient-Driven Groupings Model (PDGM) and floating several other changes, as well as the annual update to the Medicare rate. Proposed changes are...
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By Robert Holly | June 27, 2018 One measure behind home health quality of patient care star ratings may be on its way out, but another is poised to take its place. The Medicare Learning Network, an education and outreach arm of the Centers for Medicare & Medicaid Services (CMS), outlined two recommended changes to quality...
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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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