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Home Health and Hospice Industry News and Blog

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Special CMS F2F Open Door Forum


Suggested Electronic Clinical TemplateCMS recently announced they are hosting a series of special Open Door forums to allow physicians and other interested parties to give feedback on data elements for a Suggested Electronic Clinical Template for Home Health.

In order to enhance physician understanding of medical documentation requirements to support orders for Home Health services, CMS has developed a list of clinical elements within a Suggested Electronic Clinical Template that would assist physicians when documenting the Home Health (HH) face-to-face encounter for Medicare purposes.

While not intended to be a data entry form, the template will describe the clinical elements that CMS believes would be useful in supporting the documentation requirements for coverage of Home Health services. CMS will work in collaboration with the DHHS Office of the National Coordinator for Health IT (ONC) and the electronic Determination of Coverage (eDoC) workgroup which are focused on giving practitioners access to payer approved tools for the electronic submission of medical documentation.

Comments on the document can be sent to Additional information is available on the HH Electronic Clinical Template web page.

The first in the series is scheduled for tomorrow, April 22 from 3-4pm ET and it is conference call only. The instructions for participating in the special Open Door Forum are as follows:

•    Participant Dial-In Number: 800-837-1935; Conference ID # 20361722

•    Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.

The remaining forums in this series will be held on the following dates:

•    Thursday, May 8th

•    Thursday, June 19th

•    Wednesday, July 16th

Learn more about Deanna Loftus.

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What Are Home Health Software Buyers Looking For?


Cloud ComputingChoosing a home health software vendor can be a pretty intimidating task. Many times, agencies will talk with other agencies, and refer to resources such as the internet or software referral companies.

Recently, Software Advice, a company that reviews home health and hospice software, released their 2014 Home Health Software BuyerView report that uncovers the top home health software buyer trends, including top reasons home health agencies are purchasing new software, deployment preferences and the most sought-after features. They spoke with more than 350 home health software buyers across the country, revealing some key findings including:

  • 97% of buyers prefer a cloud-based system over an on-premise solution.
  • 95% of buyers are looking to replace multiple software solutions into a single suite that will meet all of their needs.

HEALTHCAREfirst offers the software and services most buyers are looking for. We provide the most comprehensive and robust suite of Web-based home health and hospice solutions in the industry, enabling our customers to adapt quickly to changing requirements and needs as well as automate agency functions quickly. For more information about how we can help you put patients before paperwork, visit our website today!

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Effective Revenue Cycle Management for Home Care


Revenue Cycle Management (RCM)Revenue Cycle Management (RCM) consists of the steps required in claims processing to ensure you are paid for the services you provide.  A solid RCM process will allow you to achieve lower DSO, lower denial rates and better cash flow.

What are some key elements to good RCM?

The RCM process starts at intake.  Collecting good insurance information and verifying insurance prior to the first visit will help prevent lost revenue due to inaccurate insurance information.  It is equally important to build the checking of eligibility into your intake process.  By checking eligibility on the front end, you will see a significant drop in your denial rate. 

The process of gathering pertinent information at intake will allow claims to be released in billing much sooner and help decrease DSO.  The result of a good revenue cycle management process will allow the billing departments to focus on a lower number of problem claims ensuring a good payment process.

As Home Health agencies continue to experience growing financial pressures, you need a proven partner to help manage your revenue cycle, providing actionable insights that will allow you to make better and smarter business decisions.

HEALTHCAREfirst offers a comprehensive outsourced billing services program, allowing you to place your billing into the hands of experts, while receiving Web-based analysis and reporting of your claims data.  For more information, click here.

Legislation to Facilitate Access to Home Health Care Services Proposed


Home Health Care Planning Improvement Act of 2013Recently, Representatives Greg Walden (R-OR) and Allyson Schwartz (D-PA) along with 19 other co-sponsors introduced legislation that would facilitate easier and timelier access to home health services under Medicare.

The bill, entitled “Home Health Care Planning Improvement Act of 2013” would allow physician assistants (PA), nurse practitioners (NP), clinical nurse specialists and certified nurse midwives to order home health services for Medicare beneficiaries.  Currently, while these types of practitioners are generally able to order nursing home care and write prescriptions for Medicare patients, they are not able to order home health care.

Stated Schwartz, “We have a responsibility to provide America’s seniors with high quality, cost effective health care.  A key part of that is ensuring they have timely access to health care services in the privacy, comfort and security of their own homes.  These highly-skilled health care professionals play a central role in the delivery of primary care, particularly in medically underserved areas and are crucial to coordinating team-based care.”

Many older adults see PAs and NPs as their primary care professionals and are often required to make an extra office visit with a physician to get the in-home care they need.  As a result, many choose not to bother with the administrative and physical burden of making another visit, which can lead to the placement of patients in more expensive health care settings or could impede receiving care at all.

According to Val Halamandaris, President of NAHC, “Studies have shown that the expanded use of these professionals can result in dramatic decreases in expensive hospitalizations and nursing home stays.  We appreciate the outstanding leadership [Reps. Walden and Schwartz] have shown in helping make home and community based services more readily available to our nation’s elderly population and those with disabilities.”

In addition to increasing the accessibility of in-home health care to the nation’s senior citizens and others, this legislation could produce significant savings for Medicare.  In a 2011 study commissioned by the National Association for Home Care & Hospice (NAHC), it was estimated that in a five year period, Medicare savings would total around $91.9 million.  Savings would result from decreased administrative burden and costs for home health agencies as well as decreased administrative burden on physicians. 

To view a summary of the study, click here.

For the full text of the proposed bill, click here.

What do you think of this legislation? Share your thoughts below!

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Senator Susan Collins Voices Support for Home Health Care

CEO Bobby Robertson with U.S. Senator Susan Collins at NAHC

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.

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Home Care Denials Webinar Recording Now Available


Top Medicare Claim Denials for Home Care...And How to Avoid Them

Top Medicare Claim Denials Webinar RecordingMany 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?

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Medicare Comparative Billing Reports


Picture of Comparative Billing Report or CBRRecently, 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.

Free Webinar: Top Medicare Claim Denials for Home Care...And How to Avoid Them


Free webinar

Click here for Webinar Handout

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.

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Commercial Home Health Billing Webinar Q&A and Recording Available


home health billing webinar Q&A
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?

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Come Visit HEALTHCAREfirst at a Home Health or Hospice Conference This Year


HEALTHCAREfirst Tradeshow ConferenceHEALTHCAREfirst 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.

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