Intermediary cracks down on vague plans of care.
Your reimbursement is riding on the details in the plan of care for your patient.
Regional home health intermediary Cahaba GBA reminds providers that the plan of care can't have a vague visit frequency, according to the RHHI's De-cember newsletter to providers.
"The order on the plan of care must specify the type of services to be provided to the patient," Cahaba instructs. It must include the professional who will provide the services, the nature of the individual services (such as skilled nursing), and the service frequency.
Don't: An example of unacceptable orders is "10 SN visits per 60 days or 4-5 SN x mo2," Cahaba explains in the newsletter.
Do: Correct orders that include duration and frequency will read "SN x 7/wk x 1wk; 3/wk x 4wk; 2/wk x 3wk., or with a range SN x 2-4 x 4wk; 1-2/wk x 4wk," Cahaba offers.
"There is potential for denial of services when a written order does not include the specific frequency of visits," Cahaba warns.
The newsletter is at
www.cahabagba.com/part_a/education_and_outreach/newsletter/1206_rhhi.pdf. • The Joint Commission on Accreditation of Healthcare Organizations is considering a new round of National Patient Safety Goals for 2008.
"The National Patient Safety Goals, which are updated annually, are designed to require health care organizations to protect patients from the negative impact of specific health care errors," the Oakbrook Terrace, IL-based accrediting body explains.
Draft goals include requiring providers to: improve recognition and response to changes in a patient's condition; reduce the risk of post-operative complications for patients with obstructive sleep apnea; prevent patient harm associated with health care worker fatigue; and prevent catheter misconnections.
JCAHO is also considering goals regarding re-duction of anticoagulation therapy risks and technology to assist with patient identification.
Comments on the proposed goals are due by Jan. 26. More information, including instructions on how to comment, is at
www.jointcommission.org. • The Centers for Medicare & Medicaid Services is gearing up to test its post-acute care patient assessment instrument. CMS plans to launch a demonstration project testing the instrument and its ability to help place patients in the most appropriate post-acute setting, the agency says in a release.
CMS is holding a special Open Door Forum about the instrument and demo Dec. 21. The agency wants provider feedback on the instrument, which will be designed for use starting at hospital discharge, and completed at inpatient rehabilitation facilities, skilled nursing facilities, home health agencies and long-term care hospitals.
More information on the instrument is at
www.cms.hhs.gov/SNFPPS/Downloads/pac_reform_plan_2006.pdf. • Suppliers of durable medical equipment, prosthetics, orthotics and supplies have a new Medicare fee schedule.
CMS released the new payment amounts on Dec. 8. The DMEPOS fee schedules are updated annually in accordance with the [...]
