When one claim is held up or rejected due to a simple error or omission, that’s easy to correct. However, if your agency has a pattern of submitting incomplete or inaccurate documentation, then you have a serious problem. Errors draw the attention of regulators, possibly leading to time-consuming audits, while re-submission of documents increases employee workload and delays payments.
Ultimately, errors can affect your agency’s cash flow and ability to thrive. That’s why many home health agencies (HHAs) turn to Homecare Homebase for help. We can help you meet these challenges – and more!
Tame the PDGM Paperwork Problem
The implementation of the Patient-Driven Groupings Model (PDGM) increased the billing workloads, affected cash flow, and caused therapy staff reductions in many HHAs. It has affected agency operations in multiple ways, including:
- RAP changes: Requests for Anticipated Payment reimbursement percentages were reduced to 20%, potentially affecting cash flow.
- 30-day payment periods: The change to 30-day payment periods require HHAs to submit two RAPs and two claims for each 60-day period of care. This single change doubled the amount of billing required under the previous system.
- CMS billing assumptions: During the launch of PDGM, the Centers for Medicare & Medicaid Services (CMS) released a set of assumptions outlining how they expected agencies to behave. While these assumptions may not directly affect billers, it is helpful to know that they exist. Agency administrators are advised to evaluate how their behaviors compare with the assumptions published by CMS.
You need home care software that supports these complex documentation requirements. Otherwise, your agency could experience more rejected claims and resubmissions.
Billing Software That Supports Payer Requirements
Home health billing is complex because you deal with many different payers. Each payer has its own requirements, but all are focused on cutting and controlling costs. Under pressure from Congress, the Centers for Medicare and Medicaid Services (CMS) have been aggressively implementing new models for care and reporting.
For example, new initiatives like alternative payment models, outcomes measurement, STAR ratings, and pre-claim review challenge providers to deliver increased value while controlling/lowering overall costs. Every change requires extra tracking, documentation, and reporting.
Software that integrates with these new policies and payer requirements can help your agency thrive through streamlined workflows, as well as real-time and defensible documentation.
Software Solutions That Work with You, Not Against You
Providers are increasingly required to provide more data, more documentation, and follow more regulations – and do it quickly and efficiently. Our sophisticated billing software guides users through the steps required to provide all necessary information. The system correctly formats the data for each payer and integrates with their specific clinical data collection requirements.
The US health care system is in a state of disruption, but that doesn’t mean your agency has to suffer. We know you don’t have time to comb through the Federal Register for announcements and updates. We have your back. Our team of experts constantly monitors payer requirements and regulatory updates.
Homecare Homebase software is always up-to-date and compliant on payer requirements. You can submit accurate, same day billing and dramatically speed up reimbursements. Virtually all of our agencies enjoy faster payments, improved cash flow and a measurable return on their investment.