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 →

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 →

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 →

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 →

Emergency Preparedness Reqs Begin November 15

A number of months ago, CMS released the Interpretive Guidelines on Emergency Preparedness for all providers.  Many have not heeded the warning and we are now at the 11th hour. Your agency must have all plans in place and all drills completed by November 15, 2017. If you have not begun the process, you are not... Continue Reading →

170 codes no longer case-mix-What do we do?

Much of my day is spent perusing Medicare regulations and Q&As, OASIS regulations and Q&As, ICD coding regulations, home health listservs, home health blogs and other social media outlets pertaining to home health care. Several months ago, there was some buzz about the Home Health PPS changes that would go in to effect on January... Continue Reading →

Part 3 – New HIPAA Rules

The following is Part 3 of Elizabeth Hogue’s series regarding the new HIPAA rules. Ms. Hogue is a nationally known expert, speaker and writer on home health law. Part 3 – New HIPAA Rules Issued: Disclosures and Revised Notices of Privacy Practices Elizabeth E. Hogue, Esq. Office: (877) 871-4062 Fax: (877) 871-9739 E-mail: Twitter:... Continue Reading →

A new version of the OASIS assessment is on its way!

On March 18, 2013 during the National Association for Home Care & Hospice’s March on Washington/Private Duty Home Care Integrated Conference & Exposition in Washington, D.C., a representative from CMS announced that there will be some significant releases in the next several months-including a draft of OASIS-C1, guidance on how new survey sanctions will be... 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 →

Is it a Pressure Ulcer or a Surgical Wound?

During a recent OASIS training class, I was asked “If a pressure ulcer is treated with a skin graft does the wound become a surgical wound?” The answer is “NO.” According to guidance, “Applying a skin graft to a pressure ulcer or burn does not change the wound to a surgical wound. The pressure ulcer... Continue Reading →

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