To Collect Or Not To Collect - That Is The Question
Make OASIS data collection decisions quick and easy with M0150. Even if you're no longer required to collect OASIS data on all private pay patients, you might want to continue doing so. "There are some occasions where agencies still will want to collect private pay patients' data," warns Rosemary Nunn-Hill, the OASIS Education Coordinator for the state of Florida. One such occasions is when patients' primary payor is private insurance, and Medicare is their secondary payor. Often, private insurance covers skilled nursing or therapy, but not home health aide services or dressing supplies that Medicare covers, Nunn-Hill explains. In those cases, and when the patient qualifies for the Medicare home health benefit by being homebound, needing a skilled service and having physician's orders for care, the home health agency can bill Medicare for those other services. The problem is that HHAs may not know right off the bat what insurance will cover. And if insurance denies payment for Medicare-covered items or services, agencies can't bill Medicare for them unless they've collected the OASIS data, even if insurance is the primary payor, Nunn-Hill cautions. So, if a patient meets the Medicare criteria and has Medicare as a secondary payor, agencies may want to be safe rather than sorry and go ahead and collect the data, she says. One way to make collection decisions easier is by using M0150 on the OASIS tool, coding expert Prinny Rose Abraham suggested in a recent teleconference sponsored by Eli. The question asks for "Current Payment Sources for Home Care. (Mark all that apply.)" If response 1 (Medicare [traditional fee-for-service]), 2 (Medicare [HMO/managed care]), 3 (Medicaid [traditional fee-for-service]), and/or 4 (Medicaid [HMO/managed care]) are marked, then clinicians should collect the rest of the OASIS data, Abraham explained. If other payors on the list are marked instead, then agencies can discontinue collecting the information. But agencies should first consider the impact discontinuing this data collection could have on their quality improvement efforts, Abraham remarked. And agencies should remember a comprehensive assessment is required for all patients, regardless of payor source, says William Dombi with the National Association for Home Care & Hospice. The big question is what will satisfy state surveyors in place of OASIS for a comprehensive assessment, Dombi notes.
