Therapy Rebilling Deadline Looms
If you haven't yet audited for underpaid therapy claims, you have only a few weeks left. Home health agencies have until Dec. 31, 2003 to fix claims for episodes from October 2001 to December 2002. One of the most costly errors occurs when you predict fewer than 10 therapy visits but provide more than 10. Your fiscal intermediary will not catch and correct this error and if you don't, you could lose about $2,000 per episode. (For more information on auditing for and correcting this mistake - even if you've already filed the claim - see Eli's OASIS Alert, Vol. 4, No. 10, p. 93.) This document provides more information about the underlying structure of OBQI reports, including definitions of the measures and detailed specifications for calculating the measures based on OASIS assessment data. To download Appendix B, go to www.cms.hhs.gov/oasis/riskadjappb.pdf. Of course, the actual takeback amount will depend on how often HHAs incorrectly reported a skilled nursing facility or rehab stay without reporting an additional hospital stay in the 14 days preceding admission or resumption of care (see Eli's OASIS Alert, Vol. 4, No. 12, p. 116). "Home care nurses are estimated to spend a much greater proportion of their time in documenting care," the IOM notes. Studies estimate "these nurses spend twice as much time in documenting patient care as do hospital nurses, in part because of more prescriptive federal regulatory requirements for documentation in home health care than in hospital care." The influential IOM recommends redesigning nurse work environments and care processes to reduce errors, including mistakes related to "completing redundant and unnecessary documentation."
