Home Health & Hospice Week

Don’t waste time and money on unnecessary RAP cancellations? Are you sure you’re billing nonroutine supplies correctly so your claims don’t start bouncing back next month? On Oct. 1 the Centers for Medicare & Med-icaid Services will begin returning claims with a HIPPS code that indicates NRS use but no supplies charges, home health agency reimbursement consultant Michelle Enger pointed out in an Eli-sponsored audioconference this summer. "The claims will start to RTP on Oct. 1, 2008, and that could be substantial amounts for home health agencies and a negative cash flow," warned Enger, with Optimal Reimbursement Strategies in Clearwater, FL. Tip: Pay attention to whether you are re-ceiving informational remark codes M50 and N59 on your current claims, suggested Enger in the audioconference, "Home Health PPS 2008 Reim-bursement Issues and How to Deal With Them Effectively." Those will be the reasons the claims system bounces back your claims when the Oct. 1 edit starts. Other tips for PPS billing success Enger of-fered include:   • Don’t waste time on unnecessary adjustments. One great thing about the major prospective payment system revisions that took place in 2008 is that the claims system now automatically adjusts up and down for number of therapy visits, Enger cheered. That means you don’t have to spend time adjusting a request for anticipated payment (RAP) that had no therapy utilization indicated when you submitted it, but then the patient needed therapy later. "There is no need to go in and cancel the RAP and resubmit it with a newer HIPPS code," Enger told a call participant.   • Avoid losing patients when they go into the hospital. A frequent complaint Enger hears from clients is that other HHAs pick up their patients when those patients come out of an inpatient stay. Strong communication with the patient, her caregiver and the hospital discharge planner is the key to retaining patients in these situations, Enger advised. Some agencies use form letters to the patient and hospital informing them that the patient is on service with their agency and requesting notification when the patient is discharged so the agency can resume care. HHAs often keep a list of patients in the hospital and communicate regularly with their families and representatives to keep tabs on the patients, Enger added.   • Educate staff on OASIS. Your patients’ reimbursement levels come directly from the OASIS assessments your staff fills out, Enger reminded listeners. "A lot of clinicians really need to have a firm grasp of how to score those questions because they are very important," she stressed. That’s particularly true under the PPS revisions, when multiple M0 items work together to determine scoring. Hot spot: A thorough understanding of diagnosis [...]