Cirque de Home Health: Juggling Payment Risks – TPE update

THIS JUST IN - TPE UPDATE! Medicare Administrative Contractor (MAC) CGS Administrators has just posted its first update to Targeted Probe and Educate (TPE) activity in nearly a year. Four more areas will receive further scrutiny. These TPE updates are in addition to Home Health Eligibility & Medical Necessary and Length of Stay (LOS) with... Continue Reading →

CASPER Reports – Not as Friendly as the Ghost

... and CASPER Reports Could Be Coming Your Way. On July 9, 2018, CMS began loading into the hospice folders letters of non-compliance for agencies who failed to meet the Hospice Quality Reporting Program (HQRP) requirements. As I am sure you know, non-compliance affects your FY19 Annual Payment Update (APU). If you haven't already checked... Continue Reading →

The RAC is Back.

We can now confirm to home health agencies: the RAC is back. More than a year after being given the okay to restart medical review activities, the Recovery Audit Contractor (RAC) for home health has posted the first Work Issue. During the hiatus of reviews, CMS updated and "improved" the RAC's process for reviews and follow-up.... Continue Reading →

Low Volume Appeals (LVA) Initiative Settlement Option, Part 3

The Low Volume Appeals Settlement Process, also known as LVA, is a new option for agencies who are waiting for ALJ hearings or MAC/DAB reviews. Take advantage of this opportunity to settle fully-denied claims. When to apply for Low Volume Appeals Settlement The dates to apply for this new CMS initiative are here! Based on... Continue Reading →

Low Volume Appeals (LVA) Initiative Settlement Option – Part 2

The Low Volume Appeals Settlement Process, also known as LVA, is a new option for agencies who are waiting for ALJ hearings or MAC/DAB reviews. Take advantage of this opportunity to settle fully-denied claims.  

Low Volume Appeals (LVA) Settlement Option – Part 1

Introducing the Low Volume Appeals Settlement Process, also known as LVA. This is a new option for agencies who are waiting for ALJ hearings or MAC/DAB reviews. QIRT highly recommends you take advantage of this opportunity to settle fully denied claims.   CMS has just provided a new avenue for agencies stuck waiting for Administrative Law... Continue Reading →

Why Your P&P Manual Must be as Unique as Your Agency

With the new Conditions of Participation (CoPs) going into effect January 13th, QIRT consultants have been receiving multiple calls from current and potential clients requesting that we provide them with a new policy and procedure manual that covers the new COPs. On the surface, this seems like an easy enough request - for a fee, QIRT... Continue Reading →

QIRT’s Joe Osentoski Discusses Targeted Probe and Educate

Home Health Care News consulted Reimbursement Recovery and Appeals Director, Joe Osentoski for his knowledge of CMS' Targeted Probe and Educate audits. In an article dated December 11, 2017, Carlo Calma detailed some of the regulation changes brought about by CMS and spoke to experts about the impacts they are seeing in the industry.

A.D. Maxim Consulting Joins QIRT

Home health industry leaders QIRT and A.D. Maxim aim to provide more service and expertise to the industry. FLORAL PARK, N.Y. - June 2, 2016 - PRLog -- QIRT (Quality In Real Time), provider of home health and hospice coding, consulting, billing and education services, announced today that A.D. Maxim and its subsidiary, CQI Coding... Continue Reading →

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