RCD: More on the CMS FAQs Update

Last week, CMS updated its Frequently Asked Questions (FAQ) on the pending Review Choice Demonstration (RCD) project. Some of these merit additional scrutiny and comment since the selection window (via Palmetto GBA’s eServices portal) has started for Illinois home care agencies. Taken from the “Review Choice Demonstration (RCD) for Home Health Services Frequently Asked Questions (FAQs)”, updated 4/18/19.... Continue Reading →

Backlog to the Future? Part 3

Home care agencies who have received additional development requests (ADRs) are experiencing an ever-increasing ALJ backlog. The following is the final part of a 3-part series on the current state of ADRs and the ALJ backlog.

Backlog to the Future? Part One: The State of ALJs

Home care agencies who have received additional development requests are experiencing an ever-increasing ALJ backlog. An additional development request (ADR) is generated to request documentation from a provider to assist with adjudicating a Medicare claim. Since 2010, the number of claims awaiting an Administrative Law Judge (ALJ) hearing has steadily climbed, along with the wait time for... Continue Reading →

It’s Alive! The Return of Pre-Claim Review… in the Form of Review Choice Demonstration

After a pause of more than a year, CMS will soon resume the pre-claim review (PCR) demonstration project in five selected states. The pre-claim review is now called Review Choice Demonstration (RCD) for Home Health Services and there are some changes. First of all, tweaks in the new process "offer more flexibility and choice for providers,... 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 →

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 →

Pros and Cons of Outsource Coding and OASIS Review

By Corinne Kuypers-Denlinger, Vice President, Post-Acute Care Growth Strategies, QIRT. Originally published in the e-newletter of the Illinois HomeCare & Hospice Council This is the first in a three-part series of articles about outsource coding and OASIS review. The purpose of this series is to help home health and hospice agencies determine if outsourcing this critical business... Continue Reading →

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