Recently, U.S. Senator Susan Collins [R-ME] wrote an article for the St. John Valley Times touting the importance of home care.
In her article, she points out the importance of shifting our health care focus from institutional care to home-based care. She also discusses that not only is home care preferred by most patients, it’s also the most affordable means of care delivery. Senator Collins goes on to say, “It costs Medicare almost $2,000 per day for a typical hospital stay, and $559 per day for a typical nursing home stay. How much does Medicare pay for home care? Just $44 a day…slightly more than two percent of the cost of a typical hospital day.”
In the article, Senator Collins expresses her concern about the cuts that home health could see under the new health care law. She says, “While home health represents just five percent of Medicare spending, it took a disproportionate 10 percent in Medicare payment cuts used to pay for the new health entitlement. Moreover, these cuts are a ‘double whammy’ because they come on top of the more than $30 billion in cuts that have been imposed by the Centers for Medicare and Medicaid Services through regulation.”
We applaud Senator Collins’ stance against Medicare cuts for home health care and we stand firm in our belief that the future of health care is in the home.
To read Senator Collins’ article in its entirety, click here
Learn more about Meghan Henry.
Top Medicare Claim Denials for Home Care...And How to Avoid Them
Many thanks to those who attended our recent webinar for home health agencies, “Top Medicare Claim Denials…and How to Avoid Them,” presented in partnership with Julianne Haydel of Haydel Consulting Services. Julianne shared a lot of great information and advice about home care denials and we hope that it proved valuable to your agency.
As promised, Julianne has provided answers to many of the questions that were asked during the webinar. To view the webinar Q&A, click here.
If you were unable to attend the webinar, don’t worry! Click here to view the home care denials recording or view the webinar handout.
We have many exciting webinars planned for home health and hospice agencies in the future. We want to hear from you! What topics would you be most interested in?
Learn more about Meghan Henry.
Recently, you may have received a Comparative Billing Report (CBR) from Medicare. What are they being used for? And how should they be interpreted and used by home health agencies?
Who Produces the Medicare Comparative Billing Report?
CMS contracted with two companies to produce these specialized reports: SafeGuard Services, LLC and A+ Government Solutions. These reports provide comparative Medical billing data on how an individual health care provider varies in comparison to other providers.
What Does the Medicare Comparative Billing Report Cover?
The Medicare Comparative Billing reports that are currently being distributed cover data from January 1, 2011 through December 31, 2011. They provide data comparing your agency against others in your state and nationally. The data includes:
- Average number of home health visits per beneficiary
- Average number of home health therapy visits per beneficiary
- Average Medicare payment per beneficiary
Why Should You Care About the Medicare Comparative Billing Report?
So what should you do with these reports? Look at the reports carefully. Check your home health agency's current averages to see how you compare to others. If your Medicare billing data is significantly different than the averages shown, you will want to make sure that you have significant documentation to support your data.
Because Medicare is collecting and reporting this data, it could be quite easy for them in the future to use it to generate ADRs in order to see why your agency is out of the "norm." You will want to address any issues you may see in your Medicare reports now.
In addition to the Comparative Billing Report, your agency may benefit from utilizing a business analytics tool such as Business Intelligence from HEALTHCAREfirst. Business Intelligence gives you valuable, real-time insight into your business practices including receivables, revenue and patient eligibility. When used together with your CBR, you will have the Medicare billing data you need to make informative, proactive business decisions before it's too late.
Not since the 1990's has the home health industry been under such scrutiny. Between RAC audits and ZPICs, there has never been a better time to proactively manage your business. Increasing denials can affect your payments, often leaving you strapped for cash.
Please join HEALTHCAREfirst and Julianne Haydel, RN, founder of Haydel Consulting Services, as she explores Medicare home health denials. Attendees will learn:
- Top home care claim denial reasons
- What to do if you receive a Medicare claim denial
- Tips and strategies to avoid future denials
You won't want to miss this opportunity to hear from one of the industry's leading experts in home care regulations and policy.
The webinar will be held Tuesday, March 5, 2013 at 10:30 am CT.
This webinar is free of charge; however you must register in advance to attend.
Click here to register for the webinar.
Thanks to everyone who attended our free home health billing webinar for home health and hospice agencies, “Billing Managed Care and Private Insurance Payers…Successfully!” We had a fantastic turnout, with hundreds of home health and hospice agencies participating.
As promised, we have provided answers to the many questions asked during and after the webinar. To view the webinar Q&A, click here.
Did you miss the webinar? Click here to view the webinar recording and here to view the webinar handout.
We look forward to offering you more webinars in the future. What topics would like to see covered in addition to home health billing? What questions do you have about billing commercial care?
Learn more about Meghan Henry
HEALTHCAREfirst will be exhibiting at a number of home health and hospice conferences throughout the country in 2013. State, regional and national conferences are a great way to learn more about the industry, network with other agencies and get up to date on the latest happenings in home care.
Are you going to be at any of the following conferences?
If so, stop by and say hello!
MI Home Health Association Software Vendor Showcase
TX Association for Home Care & Hospice Winter Legislative Conference
TX & NM Hospice Organization Annual Conference
NHPCO Management & Leadership Conference
MN Network of Hospice & Palliative Care Annual Conference
Southwest Gulf Coast Regional Home Care Conference
FL Hospice & Palliative Care Association Forum
MN HomeCare Association Annual Meeting
MO Alliance for Home Care Annual Conference
TX Association for Home Care & Hospice HCSSA Administrator Program
NAHC Financial Managers Conference
Home Care Association of FL Annual Conference
TX Association for Home Care & Hospice Annual Meeting
Carolinas Center for Hospice & End of Life Care Annual Conference
NHPCO Clinical Team Conference
OH Council for Home Care & Hospice Fall Conference
CA Hospice & Palliative Care Association Annual Conference
Midwest Care Alliance Annual Conference
NAHC Annual Meeting
TX Association for Home Care & Hospice HCSSA Administrator Program
If you are interested in Home Health Software please visit with us at one of the above shows.
Learn more about Meghan Henry
The one-hour webinar will be held on Tuesday, January 22nd at 10:30 am CT.
Many home health agencies worry about getting into the managed care business because they don't know where or how to begin.
While most are comfortable with Medicare processes and reimbursements, there is a lot of variation among commercial payers. Those agencies that are not well equipped to handle commercial billing will inevitably face rejected claims and delayed or lost reimbursements.
Please join Mary Barton, RN, Director of Revenue Cycle Management and Stephen Stearns, Manager of Billing Services for HEALTHCAREfirst as they discuss the basics of commercial billing and what you need to know to successfully bill managed care and private insurance payers.
We will discuss:
- The ins and outs of commercial billing
- Hazards you may face
- Proactive approaches to ensuring positive financial outcomes
The webinar is intended for Home Health Directors, Administrators, Executives and anyone else interested in learning more about commercial billing.
Learn more about Mary Barton.
CMS has published in the final rule effective January 1, 2013 that M1024 on the OASIS assessment will only be used for acute fracture codes. Resolved conditions of a patient are not to be coded in the home health setting, so this is to ensure compliance with coding guidelines.
In addition, they proposed a revision to the HH PPS Grouper logic to score Diabetes, Skin 1 or Neuro 1 diagnosis codes that are submitted immediately following a v-code in the primary diagnosis field the same as they are currently scored when a v-code is reported in the primary diagnosis field and the supporting diagnosis code is reported in M1024. CMS will allow you to continue to fill in M1024, but the field will no longer be used to award case mix points for an increase in reimbursement.
For example, in 2012 a patient that was admitted to home health for skilled nursing aftercare and dressing change following an amputation of the foot due to diabetic PVD would be coded as follows:
For assistance with M1024 or to learn more about our remote coding services, contact us today!
The same patient in 2013 will be coded as follows:
Note that the reimbursement will not be decreased because Diabetes follows the v-code.
At the National Association for Home Care and Hospice (NAHC) March on Washington in March, representatives from CMS participated in a panel discussion about regulatory and policy initiatives for this year. As part of this discussion, the panel identified the top ten home health survey deficiencies in 2011. They are listed below:
G158 – Written Plan of Care established & periodically reviewed
G159 – Plan of Care covers diagnosis, required services, visits, etc.
G236 – Record with past/current findings maintained for all patients
G337 – Assessment includes review of all medications
G121 – Compliance with accepted professional standards/principles
G229 – Supervisory visits if skilled care no less than once every 2 weeks
G143 – Coordination of Patient Services
G170 – Skilled Nursing Services furnished in accordance with Plan of Care
G176 – RN prepares notes, coordinates, informs MD, other staff of changes
G165 – Drugs and treatment administered only as ordered by physician
The use of home health software is incredibly important in helping to reduce errors by your staff. Most software vendors utilize regulatory compliance teams who are constantly working to ensure your software is up to date and compliant with the latest regulations.
Some software vendors, such as HEALTHCAREfirst take compliance one step further by offering products that give you complete insight into your business and financial practices. firstHOMECARE, HEALTHCAREfirst’s Web-based agency management software, has built-in alerts for field clinicians and office staff, identifying missing/incomplete documentation, personnel certification expirations and pending deadlines.
For more information about firstHOMECARE, click here.
HEALTHCAREfirst, Inc., provider of leading-edge home health software and hospice software, is is proud to honor the thousands of caregivers across the nation who allow our neighbors, friends and family members to receive the care they need, while being able to remain in their homes.
Is your agency planning on getting the word out about Home Care and Hospice this month? Here are some tips from the National Association for Home Care & Hospice (NAHC) on how to educate consumers:
- Launch a ribbon wearing campaign promoting National Home Care & Hospice Month. Pass out ribbons that can be pinned on clothing to show support for home care and its pivotal role in the end-of-life movement.
- Host an open house to bring new people into your office and to provide you with the opportunity to answer questions they may have about home care.
- Display banners and billboards announcing National Home Care & Hospice Month throughout your community. Major intersections and hospital entrances provide prime target areas.
- Organize a silent auction to raise community funds. Try to obtain a variety of commonly donated items, such as artwork, hotel accommodations, rounds of golf, restaurant certificates and gift baskets.
- Work with your local public libraries to feature books and other educational materials about home care. Provide special bookmarks highlighting the home care theme.
- Visit residents of retirement communities and provide them with general information about home care services and tips for finding and financing the highest quality care.
- Distribute brochures, fliers, and posters about home care services to local libraries, churches, pharmacies, retail outlets, etc.
Increasing community awareness of the value of in-home care can positively further the mission of home care and hospice. What is your agency planning on doing to spread the message in your area?