PDGM Record Audits

Your records provide a wealth of information. Fazzi’s expert auditors will conduct the following reviews of your records to uncover areas needing attention for success under PDGM.

  • Coding and OASIS Audit: The PDGM case mix relies on accurate primary and secondary codes and an accurate assessment of OASIS functional Items. Fazzi will conduct a side by side audit of your ICD-10 codes and key OASIS Items to assess accuracy and uncover areas where clinician education is needed. We’ll provide insight on codes that will not be accepted under PDGM and on OASIS Items that impact patient outcomes and the functional assessment portion of the PDGM HHRG calculation.
  • Plan of Care Compliance Audit: It’s important to remember that while PDGM changes payment calculation, it does not change the Conditions of Participation or other regulations. Excellent documentation will be essential as increased scrutiny will continue under PDGM. Fazzi’s full compliance audit will provide you insight on the level of excellence with overall documentation including evidence of eligibility, case coordination for PDGM clinical groups and, adherence to supplemental orders.
  • LUPA Audit: PDGM will create additional complexity in managing LUPAs with different thresholds for each clinical grouping. Preparation begins with an analysis of your current practices. Fazzi’s LUPA audit will help you determine whether LUPAs tend to be appropriate or not and – why. Fazzi auditors will review an entire episode to provide you information on gaps and successes with LUPAs that will help you prepare for the new range of LUPA thresholds in PDGM.

The minimum sample size for each audit is 20 records.

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Maximize Accurate Reimbursement and Control Risk under PDGM

As the leading outsourced coding firm in Home Health, Fazzi has a proven track record of accurate and timely coding and record review services that provide valuable feedback to clinical teams.

Under PDGM our new coding service, Payment Period Coding Review, will utilize the overlap of the end of each quality episode with each payment period transition at day 60, 120, 180, etc.. to review the REC OASIS for appropriate coding. These OASIS timepoints can then be used as a source of accurate coding for the coinciding claims at the payment period transitions.

If you are concerned about how your agency will handle coding updates at payment period transitions on day 30, 90, 150, etc., Fazzi can help. The Fazzi Coding team will review patient record coding at each payment period unassociated with an OASIS timepoint. Utilize this service to ensure claims are accurate to the patient’s presentation at each 30-day interval.

Fazzi’s Payment Period Coding Review will:

  • Maximize opportunity for accurate payment across all payment periods
  • Control risk
  • Alleviate workforce burden

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PDGM Training Series and Financial Analyzer

8 Part Webinar Series

Click arrows to read webinar descriptions.

1.) Intake Strategies for Success with PDGM (September 11, 2019)

The Patient-Driven Groupings Model (PDGM) will dramatically affect the way home health agencies are paid. It also will have a significant impact on agencies’ operations, from intake through discharge. During this session we will walk agencies through the significant home health changes under PDGM and detail how agencies should adapt their intake process as a result. This includes strategies for getting detailed documentation, questions intake staff can ask to gather additional details necessary for accurate coding, and best practices for increasing efficiencies within the intake department.

Objectives:

  • Identify the ways PDGM will affect agencies’ intake departments.
  • Increase efficiencies within their own intake department.
  • Educate their intake staff about how to gather additional detail so that the agency can code as accurately as possible.
2.) Case Management and PDGM (September 18, 2019)

PDGM preparation, Value Based environment and new CoP compliance demands a changing level of performance by our field staff. Updating your agency’s case management practice and associated leadership focus will increase the value of your service to your patients and the performance of your agency.

Leadership of process and people requires a focused understanding of PDGM Key Performance Indicators (KPIs), as well as underlying Key Performance Behaviors (KPBs) needed to move the metrics in the right direction! This training will establish these PDGM building blocks for successful leadership of effective case management and will reinforce KPIs needed for your leadership dashboard.

Objectives:

  • Reinforce KPIs for success (LUPA rates, hospitalization, productivity).
  • Discuss the tools needed to achieve them and the leadership techniques needed to guide and sustain top notch performance.
  • Identify key case management strategies to achieve best-practice clinician performance.
3.) OASIS-D1 and PDGM (September 25, 2019)

The PDGM Functional Impairment Level is based on 8 key OASIS items. Including:

  • M1800: Grooming
  • M1810: Current Ability to dress upper body safely
  • M1820: Current ability to dress lower body safely
  • M1830: Bathing
  • M1840: Toilet Transferring
  • M1850: Transferring
  • M1860: Ambulation/Locomotion
  • M1033: Risk for hospitalization

How your staff answer these 8 items could significantly impact your functional score, HHRG calculations, and ultimately your reimbursement. Never before has it been more imperative that your clinicians know how to accurately assess their patients in the home to ensure they accurately respond to these key items. This educational session explains the importance of OASIS as the foundation of goal directed, patient-centered care planning and best practices for assessing the patient’s functional abilities.

Objectives

  • Discuss best practice strategies for answering the PDGM OASIS items accurately
  • Learn how to incorporate the OASIS Walk into the SOC/ROC assessment.
4.) Preparing Your Coders for PDGM (October 2, 2019)

One of the biggest changes with PDGM are the new guidelines for home health coding. In this session we review the twelve clinical subgroups and how comorbidities are impacting case mix in the PDGM. Discussion will focus on how coders can best prepare for the new model.

Objectives:

  • Recognize the twelve clinical sub-groups and unacceptable primary codes.
  • Identify common home health codes under each sub-group.
  • Describe the steps to prepare coders for PDGM coding.
5.) Coding Comorbidities with PDGM (October 9, 2019)

PDGM includes a comorbidity adjustment category based on the presence of secondary diagnoses. It will soon be especially important for coders to code all applicable comorbidities – as depending on a patient’s secondary diagnoses, a 30-day period may receive no comorbidity adjustment, a low comorbidity adjustment, or a high comorbidity adjustment. The comorbidity adjustment is impacted by the number of interacting secondary diagnoses.

Coders need to understand that additional coding will be needed to capture all the comorbidities but there is a delicate balance required as clinicians need to be addressing these diagnoses in the care plan. Using the PDGM Comorbidity Subgroups as a guide, we will review how to code comorbidities accurately.

Objectives:

  • Review the comorbidity categories & subcategories in PDGM.
  • Discuss the 11 comorbidity subgroups and included diagnoses.
6.) Care Management with PDGM (October 16, 2019)

PDGM changes the payment model significantly while the current Home Health Conditions of Participation including OASIS and eligibility criteria remain the foundation of our clinical practice. Efficient clinician workflows, proper utilization of all services and case management oversight are vital to success in PDGM.

Objectives:

  • Describe the PDGM case mix structure and key corresponding regulations.
  • Discuss effective and realistic case management practices.
  • Discuss key service utilization strategies, including LUPA management.
7.) Service Utilization Management Training (October 23, 2019)

Success in home health continues to require organizations to develop the core competency and capability of managing care in order to maximize quality patient outcomes and satisfaction scores at the lowest cost. With the onset of PDGM, agency leaders and clinicians must learn how to best assess their patients and plan goal-directed care using the most efficient and effective multi-disciplinary visits. Utilizing the appropriate services to meet care goals while remaining efficient is not only best practice, it’s imperative for the success of your organization.

Objectives:

  • Learn how to use data to drive successful utilization management.
  • Discuss strategies, such as frontloading and the use of signifigant change in condition, to develop patient centered plans of care.
8.) Billing and PDGM (October 30, 2019)

All live webinars are from 1-2pm Eastern and on-demand webinars provided.

Bonus PDGM Financial Analyzer

Click arrows to view reports.

Agencies who purchase the webinar series now will also receive free access to our interactive PDGM Financial Analyzer. Based on 2018 claims data, our PDGM Financial Analyzer gives you a comprehensive analysis of the projected financial impact of the Patient-Driven Groupings Model (PDGM) on your agency.

With the Financial Analyzer you’ll get detailed illustrations of your agency data – comparing the current Home Health Prospective Payment System (HHPPS) and the proposed PDGM model using 2018 claims data – including:

Primary diagnosis codes not tied to a clinical group and potential loss

Primary Diagnosis Codes Not Assigned to a Clinical Group

Nursing/Therapy visit ratios for agency top 5 primary diagnoses

Nursing Therapy Visits per Top 5 DX Per 30 Day Period

LUPA percentage of visits, payment, and LUPA payment by clinical group

Count showing LUPA Breakout

Payment and cost by functional group, admission source, comorbidity

Payment and cost by functional group, admission source, comorbidity

All provided with national and state benchmarks.

Combined with the training series, you’ll get the detail you need to understand what’s driving the projected change in your reimbursement and to create your PDGM Readiness plan. Be prepared with your PDGM data during the webinar series so that our presenters can walk you through your benchmarks.

Pricing for the PDGM Training Bundle (Includes PDGM Live series, video recordings and PDGM Financial Analyzer): $999 per site/CCN. For 6+ CCNS, $699. For 10 or more CCNs, contact us for pricing.

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Case Management Certification Course Begins October 14

case management credentials
You’ve been asking for it and now it’s finally here! The next preparation course for our industry’s only case management certifications, the Certified Home Health Case Manager (CHHCM) and the Certified Hospice Case Manager (CHCM), begins October 14.

Why are these credentials so valuable:

The upcoming Patient Driven Groupings Model (PDGM) payment reform and increased scrutiny of hospice require new levels of expertise. Today, case managers must master goal directed, patient centered care planning; clinical best practices; interdisciplinary team management; time management; documentation and more – all while putting the patient first and, yes, loving the job!

About the CHHCM and CHCM:

  • These credentials can be achieved by taking the CHHCM and/or CHCM examination online through the Fazzi Learning Center.
  • An eight-week online preparation course for these examinations begins October 14.
  • With the bundle package, participants may choose the Home Health Track or the Hospice Track or they may do both. They may also choose to take the CHHCM exam or the CHCM exam or pay a small upgrade fee to do both.
  • Certificate holders get a wealth of free resources. You’ll enter a collaborative community of case management professionals and receive ongoing complimentary best practice webinars and other resources.
  • Participants will be inspired by course instructor Cindy Campbell’s expertise, energy and zeal for case management

Have more questions about the Case Management certification? View our on-demand webinar or our comprehensive FAQs. Contact us at training@fazzi.com or (844)993-2994.

Register Now

Registration Now Open for the August COQS Online Preparation Course and Exam

COQSCertified OASIS Quality Specialist (COQS) Online Preparation Course and Exam – with PDGM and D1 Preparation

The 8-week online course begins August 12- Register early to save!

Certifying OASIS proficiency is even more critical now that we have OASIS-D1 and with PDGM less than a year away! Developed by industry leading OASIS experts, the extremely popular COQS complete program includes:

  • A comprehensive, effective, engaging, convenient and affordable 8-week online preparation course and practice exam.
  • A 100-question proctored certification exam (or 80-question recertification exam) which can be taken online from the convenience of home or office. Certification demonstrates to employers and colleagues that an individual possesses the ability to accurately interpret assessment data and complete the CMS OASIS Item set in a compliant fashion.
  • A printed copy of Fazzi’s OASIS-D Field Guide to Data Collection.
  • Focused information for PDGM and OASIS-D1 Readiness.

Why is the COQS so Valuable?

  • Clinicians and other OASIS experts can obtain OASIS certification completely online with our online certification course and examination.
  • COQS certificants receive free annual competency testing, frequent webinars and “Ask Anita” sessions.
  • The COQS course and exam are unique in our industry to include concepts from The OASIS Walk® in certification, teaching and testing clinicians on the use of OASIS as an effective care planning tool in the home.
  • Clinicians with other OASIS certifications may take the COQS recertification exam at a discounted price.
  • Led by OASIS expert, instructor, enthusiast, devotee, coach and mentor, Anita Werner, the quality of the course instruction and materials is outstanding.

Certified OASIS Quality Specialist Bundle: Includes online preparation course, online exam and OASIS-D Field Guide – $449 per seat through August 6th (Regular Price $549)

If enrolling 10 or more clinicians, contact us for bulk pricing.

Register Now

Informational Webinar: Why is the BCHH-C Credential so Important and Valuable?

Find out the answer to this question and more in our free 30-minute webinar session.
Thursday, Jun 27, 2019 1:00 PM – 1:30 PM EDT

We recently announced our new offering of the 8-week online Board Certified Home Health Coder (BCHH-C) certification program and the reception has been fantastic. Many of you have already signed up for the program and others have sent us some great questions, including:

  • Why is the BCHH-C Coding credential so important and valuable?
  • How does the 8-week training program work?
  • Who qualifies to take the program?
  • How does this certification differ from other similar programs?
  • How will this course prepare me or PDGM?

Find out the answers to these question and more in a complimentary 30-minute webinar on June 27th from 1:00-1:30PM EDT.

Register Now

Why is the BCHH-C so Valuable?

  • Coders can obtain BCHH-C coding certification completely online with our online certification course and examination.
  • BCHH-C certificants receive free annual competency testing, frequent coding udpates webinars and “Ask The Expert” sessions.
  • The BCHH-C course and exam are unique in our industry to include not just ICD-10-CM concepts but also test and train in those areas of OASIS (25%) required to become an expert coder.  In fact, some employers require no additional OASIS certification when holding the BCHH-C credential.
  • Coders with other coding certifications may take the 75-question BCHH-C recertification exam.
  • Led by a team of coding experts, the quality of the course instruction and materials is outstanding.

Need to start from the beginning? Purchase Fazzi’s Total Coding Bundle

For coders not familiar with the ICD-10-CM code set we recommend purchasing our Total Coder Bundle. In addition to the certification program, you’ll receive access to our 20+ hour complete ICD-10 training program. This is a self-paced course that covers the conventions and general coding guidelines, a review of how to use the coding manual, and a chapter-by-chapter review of the ICD-10-CM code set.

For Coders already familiar with ICD-10: 8-week targeted certification course, BCHH-C exam, OASIS-D Field Guide. Early bird pricing $449 (Reg $549) ends July 3.

Purchase BCHH-C Certification Bundle

For Coders new to ICD-10: 20 hour ICD-10 complete program, 8-week targeted certification course, BCHH-C exam, OASIS-D Field Guide. Early bird pricing $749 (Reg $849) ends July 3.

Purchase the Total Coder Bundle

Become a Board Certified Home Health Coder With Fazzi’s New Coding Certification Program

The 8-week online course begins July 8th – Register early to save!

PDGM is just around the corner. Now, more than ever, certifying your home health coding proficiency is critical to achieving PDGM success! Join the thousands of coders who have already become BCHH-C certified with our new 8-week online training program. Developed by industry leading coding experts, the BCHH-C online certification bundle includes:

  • A comprehensive, effective, engaging, convenient and affordable 8-week online highly targeted preparation course and practice exam to prepare participants for the coding certification exam. Our BCHH-C preparation course also includes a PDGM module to prepare coders for January 1st.
  • A 100-question proctored certification exam (or 75-question recertification exam) which can be taken online from the convenience of home or office.
  • Fazzi’s popular OASIS-D Field Guide to Data Collection with CMS Chapter 3 guidance, Q&As and Fazzi best practice guidance.

Note: Participants need a current ICD-10-CM Coding Manual to participate in the course.

Why is the BCHH-C so Valuable?

  • Coders can obtain BCHH-C coding certification completely online with our online certification course and examination.
  • BCHH-C certificants receive free annual competency testing, frequent coding udpates webinars and “Ask The Expert” sessions.
  • The BCHH-C course and exam are unique in our industry to include not just ICD-10-CM concepts but also test and train in those areas of OASIS (25%) required to become an expert coder.  In fact, some employers require no additional OASIS certification when holding the BCHH-C credential.
  • Coders with other coding certifications may take the 75-question BCHH-C recertification exam.
  • Led by a team of coding experts, the quality of the course instruction and materials is outstanding.

Need to start from the beginning? Purchase Fazzi’s Total Coding Bundle

For coders not familiar with the ICD-10-CM code set we recommend purchasing our Total Coder Bundle. In addition to the certification program, you’ll receive access to our 20+ hour complete ICD-10 training program. This is a self-paced course that covers the conventions and general coding guidelines, a review of how to use the coding manual, and a chapter-by-chapter review of the ICD-10-CM code set.

For Coders already familiar with ICD-10: 8-week targeted certification course, BCHH-C exam, OASIS-D Field Guide. Early bird pricing $449 (Reg $549) ends July 3.

Purchase BCHH-C Certification Bundle

For Coders new to ICD-10: 20 hour ICD-10 complete program, 8-week targeted certification course, BCHH-C exam, OASIS-D Field Guide. Early bird pricing $749 (Reg $849) ends July 3.

Purchase the Total Coder Bundle

PDGM-Ready Coding Services

How Do Fazzi’s Outsourced Coding Services Help You with PDGM?

We’ve been getting a lot of questions about how our Outsourced Coding Services help agencies with PDGM so we decided to share this information with all of you. Here goes:

  • Alerts! We’ve instituted a questionable encounter alert system into our standard coding process. That means that when an agency’s documentation and coding guidance call for a primary diagnosis code that does not fit into a PDGM clinical grouping, we will alert the agency prior to RAP. That way the agency can do some intervention with the referral source/intake/clinician to see if the documentation or plan of care need to be adjusted.
  • Reports! We’re providing our clients with primary diagnosis trend reporting for insight and training purposes. (New clients can receive these reports as soon as volume thresholds are met.)
  • Accuracy! We have a long standing proven track record of accuracy. In fact, while CMS is projecting that approximately 15% of episodes will not fit into a clinical grouping, our data shows percentages for current clients to be 7%, on average. We attribute this to the skill of our coders in finding the accurate and specific diagnosis in our clients’ documentation and also the close communication between our coders and our clients when clarification is needed.
  • Advice! Our coding services include consultation, and we are encouraging agencies to:
    • Work with their referral source and clinical teams to make sure the more specific condition to the symptom code is included on the referral. One example is a patient with osteoarthritis in their legs who is presenting with a gait abnormality. Instead of coding the gait abnormality, the agency should consider coding the osteoarthritis as it is the source of the gait abnormality.
    • Work with clinical teams to make sure that when their treatment is directed at a symptom they are documenting the original source of that symptom.
  • Reduced or Eliminated Costs of Recruiting, Training and Managing Staff: Efficiency and cost control will become even more important under PDGM. (We’ll take care of your back office while you take care of your patients.)

Want to learn more about how Fazzi’s Outsourced Coding can help you with PDGM? Contact us today!

Increase Cash Flow and Get Real Time A/R Reporting

Claim management Services Produce Dramatic Results and Give You 24/7 Transparency to Your A/R Data

When you partner with us for Outsourced Billing, you of course receive timely, accurate and compliant claim submission and cash posting services. But what you might not know is that you also receive:

  • Robust claims management and follow up services.
  • 24/7 access to reports that show you the real time status of every claim.
  • Up to the minute information about A/R and cash flow.
  • Insights into the reasons for denials and ADRs.

This translates to:

  • Improved cash flow.
  • Reduced A/R.
  • Reduced write offs.
  • A clear and up to date picture of dollars coming in the door and dollars in A/R.
  • The information you need to address upstream process and training issues to further improve reimbursement.
  • Reduce or eliminate the cost of recruiting, training and managing staff.

Many of our clients are seeing up to 35% increases in cash flow from denied claims.

We don’t think you’ll find this anywhere else. That’s because we’ve built our own proprietary Outsourced Billing platform that works seamlessly with your EMR and Clearinghouse to drive billing cycle efficiencies and give you complete transparency into your data.

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SupervisionPlus Online Training Begins April 29th

We’re thrilled to announce the next offering of our popular SupervisionPlus® 8-week online course to begin April 29th, now with an advanced management track included in the program! 

Why have we developed this complete Supervisory and Management Training Program for Home Health and Hospice? Because front-line managers can have the single largest impact on your organization. A good (or bad) manager affects employee performance and satisfaction, productivity, efficiency, turnover, and the overall health of any organization.

SupervisionPlus®
The SupervisionPlus® training is a practical, how-to-do-it training. Attendees will learn about the Functional Management Model, a state-of-the-art supervisory model featured in this training. Each attendee will leave the training having learned the fundamentals of supervision plus highly practical knowledge and skills needed to:

  • Assess the competency and functional level of each of their employees.
  • Increase motivation and commitment of employees.
  • Target improvement strategies for any employee who needs it.
  • Deal with their most challenging employees.
  • Effectively delegate responsibilities and more importantly hold their staff accountable.
  • Increase employee retention and engagement.

SupervisionPlus® is a training that will help build the skill, competence and confidence of those attending the program. They will leave this session excited and ready to use what they learned to improve their support and management of their employees and team.

Bonus Management Track
In our new bonus management track, we expand on our SupervisionPlus® course and review the important interpersonal skills needed to be a successful manager. Topics addressed include:

  • Using motivational interviewing to improve employee morale and performance.
  • Building and running successful meetings with your team.
  • Becoming a successful communicator.
  • Building strong listening skills.
  • Using proven effective problem solving strategies.

This complete program gives managers the skills they need to successfully supervise and manage their staff for increased staff engagement. Those who complete both programs will be invited to attend our Home Health and Hospice Executive Quarterly Forum, which includes free quarterly webinars on key supervisory and management trends.

Pricing

Complete Supervisory and Management Program: Early bird pricing is $399 (Reg. $449) and ends April 15th. Includes FREE Supervisory Manual. Agencies that enroll ten or more people will receive the additional discount of $349 per person.

Learn More & Register!