Diagnosis queries have become an increasingly vital process to ensure adequate documentation and accurate coding. However, it is often challenging to obtain timely responses from physicians regarding queries. For instance, the demanding schedules of physicians/providers make it difficult to find an appropriate time for discussions.… Read More »Coding Query Tips and Examples
Despite no COVID-19 surge this winter, rejection rates for home health referrals have risen to an all-time high of 76%. The increase is due to staffing shortages, reimbursement setbacks, and the fact that patients admitted to home health care tend to have higher acuity. This… Read More »A Look into the Rising Referral Rejections in Home Health
The Centers for Medicare & Medicaid Services (CMS) has recently published a new set of quarterly OASIS Q&As. It includes questions received by the CMS help desks from the first quarter of this year, following the implementation of the new OASIS-E. These Q&As offer valuable… Read More »Eyes Here: April 2023 OASIS-E Q&As
The new OASIS-E emphasizes assessing patients’ cognitive function. Section C provides detailed guidance for evaluating memory, communication skills, and decision-making. The manual also includes tools to identify delirium, such as the Brief Interview for Mental Status (BIMS), which assesses attention, recall, and orientation. This section… Read More »OASIS-E Challenges and Solutions: Section C and BIMS
Knowing the top claims denial reasons from Medicare Administrative Contractors (MACs) is helpful for home health agencies aiming to maintain financial stability and ensure timely reimbursement. By identifying and addressing the root causes of denials, providers can improve their billing and coding practices, optimize cash… Read More »Top Claims Denial Reasons from MACs
Three years after introducing the Patient-Driven Groupings Model (PDGM), is your agency applying best practices and the right strategies for accurate and compliant coding? Coding has become more critical and complex with the implementation of PDGM and recent developments of guidelines regarding the relevance of… Read More »F2F Encounter FAQs: Everything You Need to Know
The Biden administration announced that the COVID-19 public health emergency (PHE) is set to conclude on May 11, 2023, after 3 years. While home health stakeholders initially feared the end of the PHE, it appears that it may not have as significant an impact on… Read More »PHE Conclusion: What Does It Mean for Home Health?
In 2023, two significant changes have been introduced to home health: the new OASIS-E and the nationwide expansion of the home health value-based purchasing (HHVBP) program. Home health organizations must be knowledgeable of the new OASIS data set and the measures impacting the HHVBP Total… Read More »OASIS-E: A Key Factor in HHVBP Performance
Home health agencies currently have the option to deliver some services using telecommunications technology as part of COVID-19 Public Health Emergency (PHE) waivers granted by CMS to allow more flexibility for providers to provide consistent patient care. However, the Centers for Medicare & Medicaid Services… Read More »Heads-up: New Telehealth G-Codes
The Centers for Medicare & Medicaid Services (CMS) have released the January 2023 OASIS Q&A sessions, which provide guidance on OASIS-E documentation in complex situations. These questions which were received by the CMS help desk from Q4 of 2022 address certain topics about BIMS interview… Read More »More OASIS-E Guidance from the January 2023 OASIS Q&As
