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Home Health & Hospice Week

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Use 8 Homebound Strategies To Make Claims Audit-Proof

Published on Wed Nov 03, 2010

The homebound verification process starts with good intake procedures. Auditors are taking a magnifying glass to home health agency patients' homebound status, but you can retain your rightful Medicare reimbursement if you know the ropes. Audits of HHA claims are on the rise from Zone Program Integrity Contractors, intermediaries, the HHS Office of Inspector General, and other authorities. And the homebound issue is often an easy target that denies an entire claim, or series of claims (see Eli's HCW, Vol. XIX, No. 38, p. 298). First: To shore up your homebound defensibility, you must examine your referrals to make sure patients really are homebound before you admit them. Ask yourself these key questions, TAG Marketing suggests in its homebound criteria flowchart -- Does the patient: leave home frequently for non-medical purposes? require assistance when leaving the home? require considerable and taxing effort when leaving the home? have a skilled nursing or therapy [...]
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