Healthy Revenue Cycle: QIRT Financial Fit List 2018

Healthy revenue cycle is crucial to a post-acute agency's overall fitness.  This is even truer now, with the new payment model on the horizon. QIRT's financial experts have created a "fitness routine" to help strengthen your agency. Make use of QIRT's Financially Fit List for toning processes and preparing benchmarks.  What does your agency's revenue... Continue Reading →

Is your Home Care Agency Ready for the Changes Being Implemented in CY 2015?

Each year, many Americans desire change and create annual New Year’s Resolutions, however, this year if you work in the Home Health Industry, resolution or not, change is coming! The first major change in the industry is the process for submission of OASIS documents and the second is OASIS-C metamorphosis into OASIS-C1/ICD-9. CMS has been... Continue Reading →

The Office of Inspector General 2014 Work Plan: home health and hospice

The United States Department of Health and Human Services (HHS) Office of the Inspector General (OIG) Work Plan for Fiscal Year 2014 summarizes ongoing reviews and activities that the OIG plans to pursue with respect to HHS programs and operations during the next fiscal year and beyond.  The focus for the 2014 plan related to... Continue Reading →

CMS releases 2014 HHPPS Final Rule

Late last week CMS published the rule that sets the 2014 Medicare home health payment rates.  The final rule is a slight improvement over the proposed rule (a net reduction of 1.05% instead of the proposed 1.5%) that was issued last June.  The change from proposed to final is due modifications of the case-mix recalibration,... Continue Reading →

Happy May Day! CMS is delaying implementation of phase 2 PECOS edits

CMS has announced that, due to technical issues, implementation of the phase 2 ordering and referring denial edits is being delayed. These edits would have checked claims for approved or validly opted out physician or non-physician who is an eligible specialty type with a valid National Provider Identifier (NPI). If either of these were missing... Continue Reading →

CMS: April 2013 Home Health Claim Hold Lifted

On April 17, 2013, the Centers for Medicare and Medicaid Services (CMS) directed its Medicare claims administration contractors to release all claims into processing that they have been holding as a result of technical issues associated with the April 2013 quarterly systems release. For more information, go to the CMS website. Until next time, M

CMS technical issues still unresolved-final claims remain on hold

CMS’ April 15, 2013 deadline to lift the hold on all home health final claims has come and gone with no fix for the technical issues. CMS sent a message via the Medicare administrative contractor (MAC) email list on April 16th stating that claims were still being held due to “technical issues with certain parts... Continue Reading →

CMS announces technical issues affecting home health final claims

The Centers for Medicare and Medicaid Services (CMS) has identified technical issues with parts of the April 2013 quarterly systems release. These issues will affect Home Health claims with dates of service or “through dates” on or after April 1, 2013. As a result, CMS has instructed its Medicare claims administration contractors to hold all... Continue Reading →

PECOS edits to begin May 1, 2013

Starting May 1, CMS will deny home health claims where the physician on the claim didn’t have an enrollment record in the provider enrollment, chain and ownership system (PECOS). CMS issued MLN Matters article SE1305 which announces the implementation of the PECOS edits and summarizes the process. The article can be found here: MLN Matters... Continue Reading →

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