Posted by Darlene Aleksza on Fri, Dec 16, 2011 @ 11:40 AM
For the 12th consecutive year, we are pleased to continue to offer the industry's very first PPS grouper tool, available online at www.ppsgrouper.com. We know there are many of you who are looking at the upcoming rate changes and need to know how they impact your agency. This is an easy method that doesn't require a download or software installation in order to use it. Even better, it's free to anyone who would like to use it!
What does PPS Grouper do?
The grouper tool allows you to enter M0090 dates in both 2011 and 2012, along with other key information, to identify the rate as it is and the anticipated rate come 2012.
How does it calculate the rate?
Information regarding the clinical, functional and services scores are entered in addition to information from the assessment to calculate the reimbursement amounts.
How can I access it?
To access the PPS Grouper Tool please visit: www.ppsgrouper.com.
We encourage you to take your agency's top HIPPS/HHRG scores and calculate the anticipated 2012 payments. As you work on your financial planning for 2012 it will be important for you, and your agency, to understand how these rates will impact your business.
Posted by Bobby Robertson on Thu, Dec 15, 2011 @ 04:33 PM
Thanks For All You Do
At the end of each year, I reflect on many things both business and personal. This would include reflections on things that were accomplished, things that weren't accomplished, relationships, opportunities and more. While doing this recently, I started reflecting on the things that I am most grateful for.
Outside of my family (including a brand new, beautiful niece), primary among them are the talented and caring group of customers we have at HEALTHCAREfirst.
Thank you for the work you do, and most importantly, how you go about doing your work. The caring spirit in which you carry out your work is why I am so proud of our industry and why I dearly value the relationship we have with you.
I wish you a wonderful Christmas and Holiday season filled with an abundance of family and friends!
Thanks for being our Customer!
Bobby
Posted by HEALTHCAREfirst Blogger on Wed, Nov 30, 2011 @ 03:00 PM
HEALTHCAREfirst, Inc., provider of leading-edge home health care and hospice technologies, is pleased to announce that on April 23-25, 2012, we will host our 2012 User Conference, Navigating the River of Change, in San Antonio, TX.
Don't forget to mark your calendars!
Through a variety of educational sessions, we will help guide you through the potential challenges home health and hospice agencies may face in the upcoming year. Sessions include:
Positioning Yourself for ACO Success with HEALTHCAREfirst
We believe a large part of your success under the new ACO initiative is getting ahead of the game and preparing for the future now. We will show you the ACO infrastructure we've created to help you facilitate effective care cycle management, including our physician portal for easy communication, telemonitoring for improved patient contact and a data reporting solution for tracking and reporting outcomes.
Preparing for ICD-10: Will You Be Ready?
You can't afford to wait until the last minute! With ICD-10 right around the corner, there is a lot of preparation your agency should be doing now. Come and listen to our regulatory and coding experts discuss key steps you should take to prepare for a painless transition.
Don't Get Z-PIC'd Apart - Surviving an Audit
You think you are as prepared as possible, but it is still overwhelming to find out you are being audited. Hear one agency's true-life experience with a Z-PIC including how it went, what they learned and how the experience changed their agency for the better.
Registration for the User Conference opens January 2012. Stay tuned for more information!
Posted by HEALTHCAREfirst Blogger on Fri, Nov 11, 2011 @ 04:15 PM
Introducing the First Mobile Application for Field Clinicians
In our latest product news development we are pleased to introduce the very first mobile application designed to work with both iPhones and Androids. Available at no charge to firstHOMECARE Enterprise and firstHOSPICE users, you now have the flexibility to use your smart phone in the field.
The HIPAA-compliant application features include:
- Alerts
Automated warnings of critical tasks that the field clinician needs to address
- Schedule
View of schedule including patient contact information and type of service
- Instant Messaging
Internal private messaging between staff members
Using the mobile application allows for easy communication, improved compliance and even more flexibility to choose devices that work best for your agency.
To learn more about this exciting new mobile application, please email us at sales@healthcarefirst.com or call 800-841-6095 today!
Posted by HEALTHCAREfirst Blogger on Wed, Oct 26, 2011 @ 11:50 AM
Thank you for stopping by the HEALTHCAREfirst booth at NAHC's Annual Meeting & Exposition in Las Vegas.
We hope that you had a chance to learn more about the web-based solutions and services we offer to home health and hospice agencies.
We encourage you to subscribe to our blog, which contains plenty of great information to keep you informed about what is happening in the home care industry. In addition, we recently awarded our first annual Compassionfirst Award to Betty Nowlin of Accentra Home Health in Oklahoma City, OK. The award was presented to Betty in honor of her many years of service and commitment to home health. You can read her incredible story here.
Again, thank you for coming to our booth. We hope to see you again next year!
Posted by HEALTHCAREfirst Blogger on Wed, Oct 19, 2011 @ 01:00 PM
The billing processes for home health and hospice are becoming increasingly more complicated. Implementing best practices in your office will provide the framework for successful billing.
1. To avoid reimbursement delays, utilize a variety of resources to check the status of claims.
Immediate access of payor websites, payor portals and DDEs, as well as making telephone calls, all enable you to identify claims issues much sooner. Checking claims response files on a daily basis ensures that any rejection is corrected and/or rebilled by the next business day.
2. Implement a “Billing Recovery” plan.
It is important to track down errant claims and get them back in the queue for processing so you can be compensated for your services. Performing LUPA and therapy audits will allow you to check if there are any missing charges resulting in lost revenue. You should also focus on outstanding A/R for the previous twelve months, keeping timely filing rules in mind.
3. Create and review billing reports.
Agencies should review monthly A/R reports to determine the status of claims. One very important report, A/R Aging, shows how much current revenue there is versus how much revenue is outstanding & for how long. The A/R Aging report should be monitored regularly, with actions being taken when necessary so the charges can be paid as soon as possible.
4. Educate your billing staff.
A knowledgeable billing staff can go a long way in making sure you bill accurately and on time. Regular training and education for billers will keep them up to date on the latest regulations and processes. Reach out to state and national home health and hospice associations for classes and trainings.
Since 2004, HEALTHCAREfirst has provided billing services to home health and hospice agencies across the country, helping them reduce overhead costs and relieving them of the burden of in-house billing.
Having Trouble With Rejected Claims? We Can Help.
Billing is one of the greatest drains on home health and hospice agencies. It takes up valuable time and requires highly skilled employees that are often hard to find and even harder to keep.
HEALTHCAREfirst’s billing experts help relieve the administrative and technical burdens of in-house billing at a highly competitive price. Their sole focus is on home health and hospice billing and they receive continual education on regulations, rules and best practices. As a result of this experience and education, you will have fewer denied and rejected claims, allowing you to get paid more quickly and accurately.
Get more information about HEALTHCAREfirst’s Billing Services or call us at 800.841.6095
Posted by Linda Hall on Wed, Aug 31, 2011 @ 09:32 AM
Evidence has shown that documenting at the point of care is a very valuable tool in quality patient care. Having work completed at the end of a day for a clinician promotes less employee stress, improved team work, and a feeling of accomplishment, but more important, is critical for the clients medical record to be current and up-to-date. Point of care documentation encourages:
Improved Safety Evidenced-based research on point of care documentation supports improved patient safety and quick identification of potential problems. For example, entering a patient's medication into the software at point of care any drug interactions are immediately identified within the medication database. Additionally, ready access to patient teaching guides allows the clinician to discuss potential side effects and interaction at the time of the visit.
Accuracy of Documentation When entering information at the point of care the potential for errors decreases. Writing the information on paper notes then transcribing it increases the risk of key stroking errors and misread or missed information. Answering Oasis questions accurately have a direct effect on outcomes and reimbursement. When documenting at the point of care, uncertainties regarding patient status can be addressed immediately.
Improved Timeliness of Documentation Documentation at the point of care allows for the assessment information to be placed directly in the patient's electronic medical record. The information is shared with all team members. The patient medical information is only transcribed once. When you receive the information from the patient, write it on a note, transcribe into record you are processing the information three times. The entire team benefits from timely documentation. The on-call staff and team have ready access to the most recent information, compliance improves and billing is not held up.
Open Medical Record Option The open medical record concept can be very empowering to the patient, if allowed by the providers. It gives patients access to their medical charts at the point of care and is a valuable tool for teaching and ensuring the best outcomes. How clinicians present point of care documentation to patients makes all the difference. The frequently heard statement is "But homecare is different" or "It will take away from the patient." The challenge would be to ask yourself, how or why is home care so different?
The era of EMR is present and not going away. Clinicians have an obligation to timely and accurate documentation for client safety and continuity. Documentation at the point of care is a key component.
Find out why HEALTHCAREfirst, Inc., provider of leading-edge home health care software and hospice software, provides the most successful point of care software solution you need to make managing home care much easier.
Posted by HEALTHCAREfirst Blogger on Fri, Aug 19, 2011 @ 03:40 PM
The following is an article written by Tim Rowan, Founder & President of Rowan Consulting Associates. In it, he describes the need for home care to change to continue to be successful in the face of changes in U.S. Health Care.
HEALTHCAREfirst has a number of products that will help home health and hospice agencies become more successful and profitable. Our firstCPO is a physician portal that allows physicians to communicate with home health agencies, hospices, labs, and more to manage accountable care through a single web-based login. In addition, we offer HEALTHCAREfirst Business Intelligence, giving agencies invaluable real-time insight into their business practices including receivables, revenue and patient eligibility.
For more information about firstCPO, HEALTHCAREfirst Business Intelligence, or any of other products and services we offer, please call 800-841-6095 today.
Home Care Must Change as U.S. Health Care Changes
The stars do not always align. When they do, if you are paying attention, there are advantages waiting to be harvested. Example: two healthcare conferences were held recently on back to back dates in the same hotel. Though both “Healthcare Unbound” and the NAHC Financial Managers meeting have always been worth attending, doing so usually requires two plane tickets. This year, all that was required was the willingness to spend a few extra days in San Diego.
The payoff for that sacrifice was a glimpse into the future of U.S. healthcare. Healthcare Unbound was originated nine years ago by and for hospitals and physicians trying to keep up with new technologies that take patient care outside hospital and clinic walls. The NAHC meeting attracts CFOs, accountants and technology vendors.
This year, both meetings reflected healthcare’s suspension between last year’s passage of the Patient Protection and Affordable Care Act (ACA) and next year’s arrival of its first real effects. Hospital administrators, physicians and home health care providers alike are anticipating the impact of ACA-mandated Affordable Care Organizations (ACO). Looking forward, all three groups arrived independently at the same prediction:
ACOs may or may not ever materialize but the practice of acute and post-acute providers working hand in hand to coordinate care, reduce hospital readmissions and lower system-wide costs is here to stay, with or without the ACO label.
Everyone will be touched by hospitals’ problem
The ACA directs Medicare to recover payments made to hospitals for unnecessary readmissions within 30 days of discharge following a stay for three conditions: heart attack, pneumonia, and heart failure. CMS will start keeping score in Fiscal Year 2013 (FY13), which begins October 1, 2012.
First year penalties for failure to control readmissions can reach up to 1 percent of that year’s total Medicare payments to the hospital. The cap rises to 2 percent the next year and 3 percent the third year. Over time, CMS will add more diseases to the list.
Why does this matter to home care?
Hospitals will begin to look for methods to control unnecessary readmissions. Experts agree they will look in three places:
- Internal operational policies and processes, including risky premature discharges.
- Technology, especially sending patients home with telehealth systems.
- Post-acute partnerships.
Over and over again in San Diego, keynote speakers and panelists at both meetings warned home health care providers to put methods two and three at the top of their most critical to-do lists. The most likely scenario sees hospitals ending the practice of discharging patients to “nowhere,” dropping them at the door with nothing but an instruction sheet and a fistful of prescriptions. These are the patients who return with the greatest frequency.
The good news is that homecare is positioned to become a hero. The bad news is that the system will not need 12,000 heroes. Many hospitals have already begun to recruit post-acute partners so it behooves administrators to know right now what hospitals need. The few destined to survive will be the ones who move now to take these steps.
- Ensure that your agency's Home Health Compare hospital readmission rates are in the top third in your market area.
- Ensure that your agency's HH-CAHPS patient satisfaction scores are in the top 20% in your market area.
- Develop hospital readmission reports in your Electronic Health Record software.
- Find the head of the appropriate department in each of your local hospitals and deliver those reports to those persons. Your goal is to sell them on the advantages of discharging to home care.
The consensus at both conferences was that hospitals will soon be in the market for post-acute partners. Your very survival as a viable home health care provider may depend on whether your local hospital or hospitals choose you over your competitors. You must be able to demonstrate, with hard data, a track record that says you can reduce rehospitalizations from the national 29% average. According to Home Health Compare, approximately one-quarter of Medicare certified agencies have already hit 23%, so we know it is possible.
You can thrive under healthcare reform but you have to make unnecessary rehospitalization rate reduction your absolute priority and you have to begin today.
Tim Rowan is the founder and president of Rowan Consulting Associates, Inc., a Colorado technology consulting firm with clients across the country. RCAI is also the publisher of Home Care Technology Report, the Visible Guide to Technology Vendor Selection, and the popular video series, Home Health Survivor. Tim has studied and reported on home care and hospice technology since 1998.
You can read other great quality articles every week by subscribing to Tim's newsletter.
Posted by HEALTHCAREfirst Blogger on Fri, Aug 05, 2011 @ 10:05 AM
Hospice care has recently received some much deserved recognition from Modern Healthcare media, being named the winner of The Big Impact Tournament, as voted on by publication’s readers. The competition was designed to honor people, events, innovations, and organizations that have had the biggest impact on healthcare over the past 35 years.
Hospice providers are some of the most humble and selfless care givers in the business of healthcare, and this award showcases just that. Over the years, hospice care has grown from grass-roots efforts and volunteer-based care into an integral part of healthcare.
In a press release discussing the win, j. Donald Schumacher, President and CEO of the National Hospice and Palliative Care Organization (NHPCO), listed the following items as “hallmarks of hospice care”:
- Patient-centered care – focusing on the wishes and priorities of those being cared for;
- Home and community-based care – empowering patients to receive care at home, nursing homes, assisted living and other settings;
- Family caregivers – supporting families and teaching them to care for their loved ones at home;
- Interdisciplinary, holistic care – delivering care and services that focus on pain management, symptom control, psychosocial and spiritual support;
Schumacher also stated, “Innovation never stops within the hospice field with many hospice organizations working to develop the continuum of care that builds on the many benefits of hospice and would bring more seamless care delivery to all individuals facing serious and life-limiting illness,”
As healthcare continues to progress and strive to provide quality, cost-effective care to patients, the topic of electronic medical records is always top of the list. By streamlining patient records and charting, medical software allows the clinicians and care givers to spend more time doing what they do best: caring for the patient.
And although Hospice Care beat out electronic health records and 62 other contenders to win the tournament, it is obvious that great healthcare is a collaborative concept and none of the nominees would be what they are without the others.
Congratulations to hospice providers everywhere and thank you for all you do.
Link for The Big Impact Tournament: http://www.modernhealthcare.com/article/20110725/SUPPLEMENT/110729979/-1
Link for the press release from NHPCO: http://www.nhpco.org/i4a/pages/index.cfm?pageID=5853
Posted by HEALTHCAREfirst Blogger on Mon, Jul 25, 2011 @ 10:00 AM
Home health and Hospice agencies today are feeling the pressure of reduced or delayed payments as well as increased expenses. It is more important than ever that billing is done right the first time, every time.
Billing oversights can lead to denials and reduced cash flow. By knowing how to reduce errors in advance, you realize the far reaching benefits of improved accuracy, accelerated reimbursement and better patient outcomes. Here are some things to keep in mind when billing for home health:
Be sure to have complete and correct patient information.
Missing or inaccurate patient information will cause claim denials. Billers should make sure that the patient insurance number is in the correct location, the admission source/referral is correct and the patient status is 30.
The diagnosis code must be valid.
Do not use codes that are marked “invalid.” Billers should keep up to date on the new diagnosis codes as they are released every October. It is also important to choose the correct code for the patient type. For example, you want to be sure you don’t use pediatric codes for adults.
The correct address must be entered to calculate the correct CBSA code for maximum reimbursement.
You need to be sure the correct county and zip code are entered. Please note the address date cannot be after the admission date.
The correct attending physician and NPI must be entered.
You must enter the physician’s full name and correct NPI number. Each of your physicians must have an NPI number.
Review your denials.
One of the best ways to educate yourself is to review your denials, keeping track of your most common denial reasons. Use this list to create a checklist that you will use to review every claim submission.
Are You Experiencing Billing Errors? We Can Help.
Billing is one of the greatest drains on home health and hospice agencies. It takes up valuable time and requires highly skilled employees that are often hard to find and even harder to keep.
HEALTHCAREfirst’s home health and hospice billing experts can help relieve the administrative and technical burdens of in-house billing at a highly competitive price. Their sole focus is on home health and hospice billing and they receive continual education on regulations, rules and best practices. As a result of this experience and education, you will have fewer denied and rejected claims, allowing you to get paid more quickly and accurately.
For more information about HEALTHCAREfirst’s Billing Services click here or call us at 800.841.6095