Recovery Audit Contractors are revealing early signs that they may soon take an interest in home care. What can we learn from the way they have been treating hospitals? A new survey indicates we can learn a lot. Nearly three quarters of hospitals believe the RAC program does reduce fraud and errors. At the same time, 60% of them find the audit process unfair. Most significant, nearly one quarter of them have had to hire additional staff to handle auditor documentation demands and short timelines.
20% of fee-for-service Medicare patients are readmitted within 30 days of discharge, and 34% return to the hospital within 90 days. Reasons cited most often are unclear discharge directions, especially for medications, and lack of follow up communication with caregivers, problems home care is uniquely positioned to mitigate. A new study of ways home care can reduce hospital readmissions is underway with results expected in time for this year’s NAHC Annual Meeting. Delta Health Technologies will underwrite the study, which will be conducted by Fazzi Associates.
More than the latest buzzword, Revenue Cycle Management is a philosophy for running a business. In today’s Medicare, Medicaid, Private Duty and non-skilled homecare services businesses, managing revenue from beginning to end means improving compliance as much as it means ensuring complete and accurate billing processes and A/R follow up procedures.
Partners 7th Annual Connected Health Symposium Payment denial/appeals consultant has urgent message for Medicare providers
Even before President Obama’s promise to hire bounty hunters to eliminate waste and fraud from Medicare, Regional Home Health Intermediaries had been stepping up their rate of payment denials. Most often, justifications to withhold payments for already provided nursing or therapy services center around “lack of medical necessity.” In case after case, attorneys and appeals consultants [...]
Dear Ms. Smith, After our long relationship as consultant and client, please know that I care for you and Mr. Smith and your business. Otherwise, I would not have gone through this much effort to draw your attention to a situation that I consider critical to your agency’s survival. I would ask that you examine [...]
In our previous story, we reprinted a letter from a payment denials and appeals consultant who told a client he would stop representing their appeals until they improved their staff’s clinical documentation skills. At the end of the letter, he offered some examples of what kind of documentation they were giving him when he argued [...]
When HCTR editor Tim Rowan travels to Albuquerque next month to address the 4-state Southwest Regional Home Care Conference about home care technology, he will make the five-hour drive from Colorado Springs instead of flying. Ask him why and he answers without hesitation, “Two-hour advance arrival times, TSA security lines, airport parking fees, cramped seats, [...]
File this one under “lesson learned…the hard way.” Incorporate it into your next staff training. This agency properly followed the government’s appeal procedure after receiving a notice of payment denial. Excerpts below show that the administrative law judge did not find the provider’s care lacking, just its paperwork. That is correct, it is not merely [...]
Cisco took its video-based medical communications system to the Consumer Electronics Show in Las Vegas this month, signaling its long-range intention to market a version of the system, which many have seen Jack Bauer use on TV’s “24,” directly to the public.
