Get the Latest Facts about Pre-Claim Review and CoP Effective Date

CMS paused Pre-Claim Review in Illinois, postponed indefinitely its start in Florida and the other states and issued a proposed rule that will change the new CoP rule effective date to January 13, 2018. The industry is abuzz with questions and Fazzi has the answers.

You will…

  1. Get the latest facts on Pre-Claim Review and the new CoP rule effective date, and
  2. Learn what you should be doing now, regardless of these changes.

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New CoPs Finalized

The Medicare and Medicaid Conditions of Participation (CoP) for Home Health have just been revised for the first time in any significant way in almost twenty years! And- they are effective on July 13, 2017.

The new CoPs include notable changes to standards related to care planning, patient rights, quality assessment and performance improvement (QAPI) and infection control.

Join Gina Mazza, Fazzi’s industry expert in Regulatory and Compliance activities for a focused overview of the key changes you should know as well as our recommendations and additional resources.

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PHI and Cyber Security in Outsourced Services

As the trend toward outsourced coding continues to spiral upward, an important consideration is the need to keep Personal Health Information (PHI) secure and to mitigate broad cyber security risks. Join Melanie Duerr, Partner, and Jami Albro-Fisher, Chief Information Officer, as they explain cyber security issues and risks and how to mitigate them in the coding process.

According to the Sixth Annual Benchmark Study on Privacy & Security of Healthcare Data, conducted by the Ponemon Institute in 2016, nearly 90% of healthcare organizations have suffered a data breach in the past two years and “criminal attacks from the outside and negligence from the inside continue to put patient data in the crossfire.”

Learn the issues and the risks and how to mitigate them in your agency, in particular as you consider the benefits of outsourced coding.

Using Fazzi’s Strategic Management Model for decision making, Mel and Jami will review 1) What’s the problem? 2) What does it mean for agencies? 3) What should you do about it?

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The 2016 – 2017 National Home Care and Hospice State of the Industry Study

The fourth biannual research project of its kind, the 2016 – 2017 National Home Care and Hospice State of the Industry Study is by far the broadest and most comprehensive with in-depth telephone interviews conducted with more than 750 agency leaders across the country.

The study includes everything from the present and future use of IT, telehealth technologies, EHR and OASIS scrubbers — to best practices in operational and clinical processes. It includes insights into what agencies are doing with Value-Based Purchasing, the growth of outsourcing, and it tells us what agencies report as their top needs. Additionally, it includes trend analysis from studies done in the past eight years. Better yet, the results show what practices and technologies are most related to higher profitability and higher quality.

With all that is going on in our field, we are extremely pleased to be able to provide you with this critical information. The goal of this study was to give agency leaders the best practice insights needed to improve operations and be more competitive.

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Big Changes And Strategic Issues For Hospice!

Gina Mazza and Carla Braveman address the compliance changes and strategic issues heading our way, including:

  • The two tiered payment model
  • Current and future data requirements
  • Public reporting

Using Fazzi’s Strategic Management Model for decision making, Gina and Carla will review 1) What’s the Problem?  2) What does it mean for agencies?  3) What should you do about it?

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Home Health Value-Based Purchasing: Rules, Risk, Reward & Recommendations

There has been so much information out there about Value-Based Purchasing (VBP), but when it comes right down to it; do you know the latest rules, how the formula works and what it means for your agency?

This webinar will teach you:

  • What the proposed VBP rule changes really mean.
  • How to assess your risk or potential reward of up to 3% of Medicare payments in 2018.
  • Best practice operational recommendations on decreasing your risk of payment reductions and increasing your chances of payment increases.

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OASIS-C2 Planning for 2017

CMS has just shared instructions on the next version of OASIS: OASIS-C2. Effective January 1, 2017, the revised OASIS will help home health agencies comply with new requirements of the IMPACT Act. The OASIS-C2 Guidance Manual includes guidance for the three new standardized items, revisions to look-back periods and formatting changes, as well as changes to response-specific instructions.

Learn about:

  • New guidance on implementation
  • New and revised OASIS-C2 items
  • New guidance on interpretation of OASIS items
  • Important next steps including best practice recommendations

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Critical Coding Updates – Diabetes, Keeping Up with the Guidance

At issue is the interpretation of the long-standing coding guidelines of the meaning of “with” in ICD-10-CM.  The interpretation is particularly significant for diabetes which has 53 opportunities to code subterm conditions listed under the main term of Diabetes.  The ICD-10-CM Official Guidelines for Coding and Reporting states at Section I.A.15, “The word ‘with’ should be interpreted to mean ‘associated with’ or ‘due to’ when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List.  The word ‘with’ in the Alphabetic Index is sequenced immediately following the main term, not in alphabetical order.”

We are seeking further clarification on this guideline, but at this juncture coding experts agree that any condition that is associated with diabetes, and is listed in the ICD-10-CM index as diabetes (by type) under the term “with”, would have an assumed cause and effect relationship according to the classification.

The Rubik’s cube of coding rules and regulations has changed again, and coders will need aggressive training on the convention guidelines of subentry and subterm.  Strict rules for physician verification have surprisingly changed.  Who would have thought that we could code conditions like gangrene with Diabetes without the physician stating that these conditions are linked? Continue reading “Critical Coding Updates – Diabetes, Keeping Up with the Guidance”

Value-Based Purchasing: Executive Briefing

Fazzi has done extensive research on Value-Based Purchasing – what is going to happen, why, what the implications are to your agency, and what you should do about them. Value-Based Purchasing is the biggest change to home health care since the implementation of the Prospective Payment System in 1997.  This change will be an opportunity for some and for others it will have negative consequences.  With potential payment changes of +/- 3% in 2018 to +/- 8% in 2020, there is a lot at stake.  The good news is you can influence your success.

Detailed information about the rule as well as clear, practical strategies and tactics for success are presented by Gina Mazza and Tim Ashe in this webinar session. The goal is to give everyone a clear sense of realities, implications, and strategies.

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