PDGM Fit List – 4 Tips for a Healthy Revenue Cycle
PDGM will rely on accurate data from all areas: from intake to final claim. Revenue cycle management has never been more important. Luckily, QIRT has created a PDGM Fit List to help agencies examine their current practices and prepare for change.
The Patient-Driven Groupings Model (PDGM) is set to go into effect for home health agencies on January 1, 2020. It is a sea change for operations, clinical, and financial procedures. PDGM will necessitate changes in multiple workflow processes to accommodate the coding impact and new, shorter 30-day payment units. In the future, agencies will need to rely on virtual visits, telephonic visits, or remote monitoring in order to decrease visits and expenses. PDGM will force agencies to examine which staff members are performing which tasks and to ensure all staff practice at the top of their abilities and/or licensure.
Tip #1: Make Technology Work For You, Not Against You
Modern technology is steeped in paradox. It is a remarkable gift that often feels like a curse. Many tools promise the world at your fingertips, yet leave you stuck in front of a screen for hours staring at a user guide.
Technology leaves me feeling out of control
It’s time to adjust priorities. Be sure your newest priority is to develop a strategic vision for technology adoption. In PDGM, technology is now our workforce partner, as fewer resources may be available in an accelerated timeline. Successful technology adoption begins with taking a step back and analyzing your workflow from a bird’s-eye view. Contemporary solutions exist that allow for infinite minutiae. The goal of revenue cycle management (RCM) is to chisel away at the extraneous until what is left is a streamlined process falling within compliance guidelines. Therefore, keep this in mind as you shop for solutions, to help prevent the “informational overload” and transactional overhead that plague many agencies.
What can I do now?
- Reexamine processes: commitment to doing the work the way you have been doing it may not get you very far in the world of PDGM
- Begin your preparations now: change is happening rapidly; it takes time and energy to learn
- Must accommodate change while running agency at the same time
- Encourage culture or behavior changes in your agency at this time
- Lean on available technology for updates, reports, and dashboards: it will need to become your workforce partner if it is not now
- Make task-minded decisions. For every task assigned within your agency, you now need to ask: Can an administrative person do this task? Who would that be? Can technology do this task and what type of technology?
Our agency currently uses an electronic medical record
Great! Utilize 100% of your electronic medical record’s (EMR) capabilities. Check in with your vendor to ensure your agency is using the EMR to its full capacity and also find out what is your vendor doing about PDGM upgrading. Remember, you must train your staff members on how to access reports.
Additionally, here are some other helpful tips:
- If you are implementing the EMR, follow its processes, not yours and do not create workarounds.
- All levels of staff must have access to dashboards.
- Create a policy on no cutting/pasting into the EMR, it is a huge liability to your agency
- When you check with your vendor to see where they are with moving towards PDGM, ask them questions about what they are doing now. This will involve a lot of work on your vendor’s part, so they need to be moving toward the finish line like you are.
- Create a solid QAPI process to ensure workflow processes are being carried out and audited.
Outsource Your Billing with QIRT Financial
Need more help?
Our QIRT experts have created PDGM tools to assist with your home care agency’s preparations. Be sure to make good use of this QIRT advantage…on us! PPS to PDGM Crosswalk
Tune in next week for QIRT’s PDGM Financial Fit List: Tip #2.