Home Health Blogger

PDGM Home Health Billing: Significant Change in Condition (SCIC)

The home health conditions of participation (CoPs) require that agencies update and revise the current OASIS assessment under the following conditions:

(1) The last 5 days of every 60 days if the patient is to be 're-certified', unless there is a beneficiary-elected transfer,

(2) a...

Posted by Melissa Cott on Feb 12, 2020

5 Billing Basics for Perfect Medicare Home Health Final Claims

The path to fast payment of a home health final claim is a no-brainer – make sure the Final is error-free.  Medicare rejects a claim on an error-by-error basis. You can fix one mistake and the inspector then re-examines the claim for other inconsistencies.  This can be exceedingly...

Posted by Peggy Mathews on Feb 28, 2019

Home Health Care Billing: A RAP is Just a Loan

Home Health Care Billing: I am constantly surprised at how many agencies authorize RAP after RAP and then seem to forget about the final claims. It’s great to get that advance payment and use it as Medicare intended, in order to keep your agency humming along. One must remember...

Posted by Trevor Harris on Jan 21, 2019

A Beginner's Guide to Home Health Billing

Home Health billing is full of detail and can be frustrating. Submitting claims to different payers takes ALOT of time because each payer has lots of little rules and terms for which you will be unfamiliar. Your software will only HELP you submit claims but it’s only a tool and you...

Posted by Debbie Bartlett on Mar 8, 2018

Are Your Physicians Billing Home Health Claims for CPO?

'Care Plan Oversight' can earn physicians thousands per month. Provide the following guidance to physicians to enhance your referral-building relationships.

adapted from the Medicare Learning Series: Care Plan Oversight (CPO) is physician supervision of patients under either the...

Posted by Melissa Cott on Jan 23, 2018

Proper Home Health Coding for Medicare OASIS

Proper home health coding for Medicare OASIS

The process of selecting correct diagnosis codes for a OASIS Start of Care, Re-Certification or Resumption of Care is very straightforward and uncomplicated.

Posted by Peggy Mathews on Feb 15, 2017

Denial of Home Health Payments when OASIS is not Received

Medicare Change Request (CR) 9585 directs Intermediaries to automate the denial of Home Health Care Billing Prospective Payment System (HH PPS) claims when the condition of payment for submitting patient assessment data has not been met on MyHomecareBiz. Make sure that your HH...

Posted by Peggy Mathews on Jan 2, 2017

Home Health Billing: 2017 CMS Changes to Quality Reporting

Section 2(a) of the Improving Medicare Post-Acute Care Transformation Act of 2014 (the IMPACT Act) requires the public reporting of data on HHAs, Skilled Nursing Facilities (SNFs), Inpatient Rehabilitation Facilities (IRFs), and Long-Term Care Hospitals (LTCHs) quality measures and...

Posted by Peggy Mathews on Nov 28, 2016