Home Health & Hospice Week

Your supplies payment depends on how well your clinicians and billers communicate.

Fine tune your nonroutine supplies processes so you don't miss out on significant reimbursement after the short-lived grace period concludes.

Home health agencies may be in a NRS edit grace period now, but all too soon mistakes with NRS claims will be taking money out of your pocket. Use these tips from NRS experts to get your supplies billing up to snuff: 1) Know what counts. Your staff need to understand the difference between routine and nonroutine supplies, says M. Aaron Little with BKD in Springfield, MO. You must report NRS charges on claims, while routine supplies are bundled into the PPS episode rate and aren't reported separately.

This is the most common NRS question agencies ask, said NRS expert Lynda Laff in a recent Eli-sponsored audioconference about supplies.

The Centers for Medicare & Medicaid Services says NRS are "those supplies needed to treat a patient's specific illness or injury in accordance with the physician's plan of care," said Laff, with Laff Associates in Hilton Head Island, SC. Basically that means supplies that are specific to a patient and require an order.

CMS says routine supplies are "those supplies customarily used during the course of most home care visits. Routine supplies are usually in-cluded in the clinician's supplies and not designated for a specific patient," Laff continued. Examples are thermometers, alcohol swabs, applicators, infection control supplies and lab draw items, she said. 2) Get your NRS use straight. Your agency must be able to accurately record the NRS it furnishes to patients. For some agencies, that's as simple as creating a supply sheet for clinicians and educating them on how to correctly report the supplies, says consultant Michelle Enger with Optimal Reimbursement Strategies in Clearwater, FL. For others, a complex change to their computer system to facilitate internal supplies reporting is needed.

Adequate processes must be in place to ensure you are consistently recording NRS charges and that that information is always flowing to final claims, Little advises.

You must verify "whether controls, communication and processes are effective and efficient," he tells Eli. Billers must "be confident that if NRS do not flow over to final claims, it's because NRS were not provided to the patient rather than a communication/process breakdown or software system error."

Your clinicians need to know how PPS reimbursement works to emphasize why it's important that they diligently record NRS charges and code the patient correctly to obtain the correct NRS payment level, Laff emphasized.

3) Know how to bill. HHAs have only two supplies codes to use on claims--0027 for general supplies or 0623 for wound care supplies. And agencies must report units and charges for the supplies, regional home health [...]