Posted by Darlene Aleksza on Mon, May 14, 2012 @ 03:33 PM
January 1, 2011 the Face to Face encounter became part of our day to day routine. The requirements put the majority of the burden on home health agencies to ensure that the documentation is completed within the appropriate timeframes. The requirements identify implications for the home health agency that does not get the signed documentation, but do not have an implication for physicians.
We know that physicians are in the same place many agencies are. Too much to do and not enough time to get it done. Paperwork, or documentation, is overwhelming everyone.
As you know today the only individuals who are able to sign home health plan of care documentation are "physicians". Enter the Home Health Care Planning Improvement Act (S. 227, H.R. 2267). This Act, if passed, would allow Nurse Practitioners (NPs), Clinical Nurse Specialists (CNSs), Certified Nurse Midwives (CNMs), and Physicians' Assistants (PAs) to certify Medicare home health plans of care.
The Official Summary posted in Open Congress, states:
1/31/11 -- Introduced Home Health Care Planning Improvement Act of 2011 - Amends title XVIII (Medicare) of the Social Security Act to revise conditions of and limitations on payment for home health care services. Allows payment for home health services to Medicare beneficiaries by:
(1) a nurse practitioner,
(2) a clinical nurse specialist working in collaboration with a physician in accordance with state law,
(3) a certified nurse-midwife, or
(4) a physician assistant under a physician's supervision.
The National Association for Home Care & Hospice (NAHC) has posted talking points and has an email template that you can send to your representatives urging them to support the Act. Among the talking points they identify the need for the legislation, in part to help with the increase in providing medically necessary services to Medicare beneficiaries, particularly in rural and underserved areas. In some cases the NPs, CNSs, CNMS and PAs are the individuals who are most familiar with what's happening with the patient, and therefore it may be the best individual to sign off on the plan of care documentation.
We encourage you to support this legislation and contact your representatives to request their support.
Keeping track of clinical documentation and passing documents back and forth between your agency and physicians can involve a lot of wasted paper and time. HEALTHCAREfirst's firstCPO product allows your agency to send documents to physicians, electronically. Contact us today for more information!
Posted by Claire Potter on Thu, May 03, 2012 @ 03:15 PM
I want to extend a very heartfelt and special Thank You! to each and every one of our clients who attended this year in San Antonio. I hope that you all went home with a wealth of knowledge and excitement about your HEALTHCAREfirst products and services.
Last week was packed full of learning opportunities and fun! Our customers had a chance to meet with other product users, discuss common issues and experiences, while building long-lasting relationships. It truly was a delight to see so many connections being made.
For those of you who were unable to attend – here are some of the highlights of what you missed:
Vice President of Product Management, Stan Harter started the conference off on Tuesday showcasing What’s New and coming attractions for the Enterprise Edition firstHOMECARE and firstHOSPICE products, including a billing engine rewrite, visit routing/mileage optimization, a new event log/reporting tool, and so much more. Clients were thrilled to be the first to learn about these exciting new changes and the feedback was overwhelmingly positive.
The Answer Room was a huge hit! Clients enjoyed getting to meet some of the technical support representatives that they speak with on the phone and also received personal, one-on-one help with any issues or questions they had. The room was always full of customers interested in getting help, seeking advice and just saying hello.
We introduced Birds of a Feather focus group discussions this year – giving clients with similar responsibilities the opportunity to network and discuss how they use the product and what is working for them. This was a highlight of the conference for many clients. The conversation was so good that it was hard to get the discussions to stop so we could move on to the next session!
Our Surviving an Audit roundtable discussion with Julianne Haydel of Haydel Consulting, Stan Harter, VP of Product Management and Deanna Loftus, Director of Regulatory Compliance, was excellent. It provided great information and painted a real-life picture of what an audit is like and ways agencies can avoid being targeted. Our clients asked many great questions and the interaction between everyone was incredible.
Monday night, we hosted our Welcome Reception at the Hard Rock Café and watched the Fiesta River Parade go by from our balcony views. The reception gave our clients a great opportunity to get to know each other as well as the HEALTHCAREfirst staff. Between networking, meeting people, and checking out the decorated parade boats, fun was had by all!
In the next couple days, you will receive a survey via email asking for your opinion on the conference (for attendees) or why you were not able to attend (non-attendees). Please take a moment to fill this out – your feedback is vital in helping us plan for future conferences and events.
Over the coming weeks, we will be putting together a CD with recordings and handouts from the sessions. Agencies that attended the conference will automatically receive one of these CDs in the mail. If you were not able to attend, be watching for an order form to get your copy!
The 2012 User Conference was our best yet, and we can’t wait to see what future conferences will bring! From all of us here at HEALTHCAREfirst, thanks for being our customer!
Claire Potter
Posted by Denise St.Pierre on Tue, Apr 17, 2012 @ 09:00 AM
Each year, HEALTHCAREfirst is proud to attend NAHC’s March on Washington and this year was my first time to attend. What a great opportunity to join together with the HEALTHCAREfirst team, our customers and other Home Health agency owners, administrators and clinicians to highlight the importance of the home care industry as well as help Senators and Representative put a face and name to the issues they are being asked to vote upon.
We were able to speak with many congressional leaders about what home health is and why it matters. The Senators, Representatives and staffers listened, asked questions and took notes. We explained the cost advantages of providing home health and hospice services to patients in their own home and how home care allows the aging to live independently by providing vital services, as well as support to the family, while improving a patient’s quality of life. We also discussed topics such as:
- No co-pays for home health
- Establishing reasonable and fair standards for rebasing Medicare home health services payment rates
- Promoting full market basket updates for Medicare home health services
- Expressing support for the home Health Care Access Protection Act (S. 659)
While meeting with one of the Senators from Texas, the topic of RAC and ZPIC audits was discussed. Agency owners described the disruption the audits have caused to their businesses and that the audits were taking time away from caring for their patients. He listened to their stories and then asked for their opinions on how the process could be changed or improved.
We also had the opportunity to meet with Congressman Ralph Hall from the 4th District of Texas. Congressman Hall was first elected to the U.S. House of Representatives in 1980 and has been re-elected to each succeeding Congress. It was an honor to talk with him about the issues the home care industry is currently facing. He even took the time to take a photo with our group!
This was such an eye opening experience for many of us! Our voices really do matter. So, if you didn’t have an opportunity to personally visit your Congressman in Washington, DC, I encourage you to write, email or call them and be heard.
This was such a wonderful experience and I wanted to personally thank everyone who helped me along this journey….we can’t wait until next year!
Denise St. Pierre is the Operational Program Manager at HEALTHCAREfirst. She is responsible for maintaining and updating the software to ensure that it continually meets all regulations and mandates.
Posted by Darlene Aleksza on Tue, Mar 27, 2012 @ 10:10 AM
You've selected new Home Health Software and/or Hospice Software. Now what? To continue the analogy of our last Best Practices blog (Choosing a Homecare Software Vendor), it's now time to "move in" together. We'll call this implementation.
I worked in implementation for a number of years. This is an area where there are many agencies that excel, and others that feel completely overwhelmed. You've spent a lot of effort to find the perfect homecare software solution for your business. Now that you've got it, what do you do with it? Some agencies proceed thinking "now I'll get trained and I'll be on my way”. That would be part of it, but it's not all of it. I have a friend that refers to a process of operationalizing the software. This, in my opinion, is bigger than training. That's not to say training isn't important, it is. It's just not all of it.
How do you make sure you operationalize your new homecare software solution? I put together some of my tips. I also asked our Director of Implementation, Shawn Brandwein, and others for their thoughts. The list below is a combination of our suggestions. Again, this is not the “be all, end all”, list of all things to consider when implementing Home Health Software and/or Hospice Software. It's a starting point.
Engage your team early in the deployment process. Share with them all of the wonderful ways the system will help them. Acknowledge that it will be change, and it will take effort, but as an organization you're committed to making it successful. To do so, you need their help. Encourage them to embrace and evolve with the changes. The end results will help them, the agency and most importantly, your patients.
What "has been" doesn't have to be what "IS". (Look at your processes… now is a great time to change them and make them work even better!) Align your processes and people to exploit the best aspects of your new software. Just be careful of trying to change too much at one time.
Going from paper to electronic is a big change. Try to keep in mind that it's not always appropriate to do/keep all of the same paper processes and procedures as you move into the electronic world.
Ask your vendor for their recommendations and suggestions. They've helped hundreds of agencies implement their solution. What are the things they've seen work? What things have they seen that didn't work out so well? This will help you make more informed decisions.
Implementing a new system takes effort. In many cases you've put a significant investment in selecting a homecare software vendor. Rushing or short-changing the implementation process can take your beautiful new system that you worked so hard to select and leave you with less than optimal results. A solidly configured system that is used well by your users will increase your ROI and likely, the happiness of your organization.
Support your implementation team. Generally agencies don't have people on-staff that are able to focus all of their time on the software implementation/s. Ensure that the individuals who are working on the project and leading the internal efforts have executive support and are empowered to make decisions. Take time to make sure they feel appreciated.
Expect a couple of bumps. What major change doesn't involve at least a bump or two? This doesn't mean expect a derailment but expect a couple of bumps. If they don't happen, that's awesome! If you see a "bump" in the road coming, call it out. Determine a mitigation plan. Can you take a "detour"? Should you "slow down" so you don't hit it at 75mph? Making informed decisions will help you and your agency minimize the overall effects of the bump.
Chart your progress. Celebrate the milestones as an agency. It's exciting to be implementing something new!
At the conclusion of your implementation you will look back and recognize some lessons learned, but more importantly see a more efficient and better ability to Focus on Patient Care, Not on Paperwork. If you have some best practices suggestions post them here or on Facebook or Twitter! We’d love to hear from you!
Are you thinking of implementing a new homecare software solution? Let us help! We can provide not only homecare software but also billing & coding services, business intelligence, a physician portal that helps docs track care plan oversight time and much more! Contact HEALTHCAREfirst today for more information!
Posted by HEALTHCAREfirst Blogger on Wed, Mar 14, 2012 @ 04:47 PM
This Thursday is the Early Bird Deadline for the 2012 HEALTHCAREfirst User Conference
Were you thinking about attending the HEALTHCAREfirst User Conference next month? There is no better time than now to register! If you register before this Thursday, March 15th, you will save $100 OFF the registration fee.
This year’s conference is all about “Navigating the River of Change.” We have experienced a lot of changes in the industry and will continue to see even more. The conference gives you an unmatched opportunity to learn more about positioning your business for success using your HEALTHCAREfirst solution.
No matter which product you use, we have planned something for everyone. In addition to product specific sessions, our home health customers won’t want to miss these sessions designed just for you:
- 2012 Regulatory Update
- Business Intelligence: What Your Data is Trying to Tell You and Why You Should Listen
- Care Cycle Management Success with HEALTHCAREfirst
Along with the educational sessions, we have planned some fun activities to present you with both formal and informal networking opportunities such as an exciting golf tournament and welcome reception at the Hard Rock Café.
For more information about the 2012 HEALTHCARE
first User Conference, or to register today,
click here.
Posted by HEALTHCAREfirst Blogger on Mon, Feb 27, 2012 @ 03:00 PM
The webinar recording can be accessed by click here.
Click here to view and print a copy of the webinar handouts.
Please join us for a free webinar discussing the ins and outs of commercial payers and home care including:
- How to get into the commercial care business
- How to be successful with commercial
- Pitfalls to be aware of when starting out
Audience:
This webinar is intended for Home Care Executives, Administrators, Directors and others interested in providing commercial care.
The webinar will be held on February 28th, 2012 at 10:30 am CT.
To register for the webinar, click here. There is no charge for the webinar, but you must register in advance.
Posted by HEALTHCAREfirst Blogger on Fri, Feb 24, 2012 @ 04:30 PM
Don't Be a Statistic! Accurately Code & Bill Your Claims
On February 14, 2012, the Health Care Fraud Prevention and Enforcement Efforts announced that their efforts recovered nearly $4.1 billion in taxpayer dollars in Fiscal Year (FY) 2011. This was the "largest sum ever recovered in single year" from Medicare overpayment and healthcare fraud.
To combat fraud, the OIG workplan for 2012 reports that CMS will be implementing Medicare Administrative Contractors' Oversight of Home Health Agency claims. One of the purposes of these MACs is to reduce payment errors by preventing initial payment of claims that are not compliant with Medicare's coverage, coding, payment, and billing policies. To detect and deter fraud, MACs may use a variety of methods such as, but not limited to: data analysis, prepayment claim reviews, postpayment claim reviews, extrapolation claim reviews, and medical reviews to target and identify claims and/or providers with suspicious characteristics.
What should you do to prepare?
- Create an internal audit to make sure your OASIS assessment supports what is being coded.
- Educate your staff on the most current updates with CMS and ICD-9 coding guidelines.
- Never upcode your claims. Sometimes this is unintentional due to lack of documentation, but only code what is documented. If you aren't sure, call the physician and get clarification.
- Get familiar with the steps to file an appeal should the need arise.
By focusing on what you can do now, you will reduce the likelihood of any hiccups in the future.
Posted by HEALTHCAREfirst Blogger on Wed, Feb 22, 2012 @ 10:33 AM
Managed care is growing and this is only the beginning! Are you missing out on these business opportunities? You are invited to join us for a FREE webinar for home health and hospice agencies entitled, “Working with Commercial Payers.”
Medicare is reducing home health payments, causing home care agencies to look for ways to increase their revenue. One source that you might consider is commercial payers. However, cash flow can be a problem as you begin to work with commercial payers. Don't get caught unprepared!
Please join us for a free webinar discussing the ins and outs of commercial payers and home care including:
- How to get into the commercial care business
- How to be successful with commercial
- Pitfalls to be aware of when starting out
Audience:
This webinar is intended for Home Care Executives, Administrators, Directors and others interested in providing commercial care.
The webinar will be held on February 28th, 2012 at 10:30 am CT.
To register for the webinar, click here. There is no charge for the webinar, but you must register in advance.
Posted by Claire Powell on Tue, Feb 07, 2012 @ 10:35 AM
How often are we asked the question “Would you like paper or plastic?” at the grocery store? When paying for your items, do you use cash or credit? How many different thoughts or aspects factor into your decision either way? Do you consider the environment, bank accounts, simplicity?
I recently had the pleasure of visiting with a couple of our clients to talk with them about the transition from paper documentation to online point of care documentation. During our discussions they referred to the change as “Paper versus Plastic”. This initially made me chuckle, but then got me thinking. What are the benefits of “going plastic” and what steps should you take before making the switch?
In my opinion, the pros of going point of care far outweigh the cons. Yes, you may have the initial resistance to change, overhead cost for devices, and training curve for your staff. Now imagine, if you will, the efficiency, accuracy, and overall happiness of your clinicians who no longer need to carry 5-6 paper charts each day or come to the office before and after visits to switch them out and sign documents. Think of your patients’ care improving as a result of the clinician having real-time information at her fingertips, rather than hoping that the clinician that visited yesterday completed their note and filed it in the patient chart. Envision your management team being able to do chart reviews without being buried by piles of paper. This is the reality of a point of care agency – and you can get there.
One of the biggest hurdles that agencies making the switch may have, is the change in content. On paper, clinicians have the freedom to create their own notes and assessments. In an electronic system, assessments and visit documentation is most likely built-in. In addition, the content may be very different from what they’re used to.
Establishing a way to make the transition is important for any agency making the switch. My “first-things-first” suggestion is to get blank copies of your system’s electronic notes. Print them and have your clinicians start using them on paper. This will enable you to introduce them to potentially new content while keeping your current process and procedure intact. You may also have an opportunity to make suggestions or requests to your software vendor during this phase. This will help you get everyone on board and ready for the change.
Next, ensure you have a solid understanding of your current-state processes. Keep an open mind, however, and be flexible to change. Going electronic will necessitate changes to your current procedures. Don’t fear this. It’s a good thing! Once you have your current processes outlined, walk through the system and create a roadmap for the new ones. Being able to tell your staff “this is what we used to do and this is how we’ll do it now” will not only help with the transition, but it will show your clinicians that you have completely thought through the transition and are committed to making it as easy for them as possible.
Now it’s time to get your clinicians online. Where do you start? My suggestion would be to select clinicians with the strongest computer skills and best attitudes – the ones who are most likely to succeed and do well with the new process. Train them and let them start slowly. Go out to do their visits and then come back to the office for support as they work to enter their notes into the system. They can also help with suggestions on optimizing the new processes and with working out any kinks in the process.
After your first group is proficient, begin to train the rest of the staff. Use the same training process as with the first group; allowing them to come back to the office and be supported as they get used to the electronic documentation. Be advised, expectations surrounding productivity may need to be adjusted during this time period. Over a couple of weeks they will increase proficiency such that they can return to normal productivity. Also keep in mind that some clinicians may have a greater learning curve than others. Be supportive and flexible. They will get it!
When you feel like you’re ready to make the leap, be sure to visit with your vendor to put together an implementation plan. The more support you have, the more successful your transition will be. They have a wealth of experience and can help with advice and answers to your questions along the way.
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.