Home Health & Hospice Week

Functional domain scores, diagnosis items can lead reviewers to your weak spots. One way to protect yourself against the most common home health agency denials is to ferret out your at-risk patients and proactively beef up their documentation before their claims come under scrutiny. Denials for homebound status and medical necessity top HHH Medicare Administrative Contractor Palmetto GBA's HHA denial list for the most recent quarter (see related story, p. 338). You can find patients who may have problems in this area by using your OASIS assessment, advises consultant Lynda Laff with Laff Associates in Hilton Head Island, S.C. Do this: "Look at OASIS functional scores to determine whether F scores are 2 or above," Laff instructs. "If not, the patient may not be homebound. Any patient scoring as independent or requiring only minimal assistance (use of a device) to ambulate could be considered not homebound and [the Centers for [...]