The changes the home health industry has endured under PDGM have affected every part of your agency. After a month of focusing on changes to OASIS and documentation, it’s now time to spend time focusing on the back office.
One of the many sweeping changes put in place under PDGM was the move to 30-day payment periods. This change has major implications for nearly every part of your agency. Shorter cycles will likely have increased the number of claims that your billing department submits.
To keep up with the increased number of claims, your billing process must be efficient. Use this tip sheet to learn why your agency should focus on:
- The process for orders management
- Timely OASIS documentation and submission
- Standardizing the process for correcting bill-edit errors
As the population ages and the demand for hospice and palliative care grows, hospice agencies are faced with regulation changes as the Centers for Medicare and Medicaid Services (CMS) aim to create a care continuum focused on value-based care.
With PDPM and PDGM already implemented in the connected spaces of long-term care and home health, hospice agencies should be sensing greater change on the horizon. Monitoring 2019 industry topics and trends predicted to impact hospice agencies in 2020 is the first step to get ahead and stay ahead of the competition.
In this detailed report, Catherine Dehlin, RN, BSN, CHPN, CHCM, COQS, Director of Hospice and Palliative Services for Fazzi Associates, breaks down some of the biggest trends that hospice agencies will face in 2020.
Download this free white paper to learn:
- How pending federal legislation will impact agencies
- Why new assessment tools will be used and how they will impact every facet of the industry
- What factors are impacting the financial outlook of the hospice market
PDGM is a major regulatory change that will impact every aspect of your agency. As each department prepares for inevitable changes, it’s important to ensure your agency is on track as whole. To do this, you must prioritize tasks.
With 30 days left until PDGM is implemented, it’s important to prioritize tasks that help create a sense of normalcy at your agency. Staff, no matter the department, need to start creating habits that make new policies and procedures second nature. Fazzi’s 30-day PDGM timeline can help you do just that.
Download the tip sheet to learn:
Why December 27th is an important date for you and your team
- Why testing the claims process in your agency’s software is critical for success
- How a decision team can help you track your agency’s PDGM progress
For years the base-payment rate for the level of care provided by hospice agencies has remained unscathed by large-scale adjustments. After identifying misalignment through regulation changes, CMS realized something needed be done to help create payment accuracy.
To better align base-payment rates, the CMS 2020 hospice final rule includes a significant rebasing of hospice payment rates. In this free white paper, Catherine Dehlin, RN, BSN, CHPN, CHCM, COQS, Director of Hospice and Palliative Care Services at Fazzi Associates, explains the history of hospice rebasement and how the new alignments can impact your agency.
Download the free white paper to learn:
- Why realignment of hospice repayment was needed
- How repayments have changed
- How your hospice agency will be affected
- What your agency should do to lessen the financial impacts of these changes
PDGM is a major regulatory change that will impact every aspect of your agency. As each department prepares for inevitable changes, it’s important to ensure your agency is on track as whole.
To do this, you must prioritize tasks. To help prioritize tasks, it’s important to understand where you should focus your resources. Fazzi’s PDGM timeline can help you do just that.
Download the tip sheet to learn:
- Why department specific team meetings will help your team prepare for PDGM
- Why December 27th is a date that should be on your agency’s radar
- What coding best practices should be in place for your agency’s success
The Centers for Medicare & Medicaid Services (CMS) issued the 2020 final rule on October 31, reinforcing the plan to implement the Patient-Driven Groupings Model on January 1, 2020. With PDGM just 60 days away and so much to do in so many departments, it can be hard to know what tasks should be prioritized over others.
To help prioritize tasks, it’s important to understand where you should focus your resources. Fazzi’s PDGM timeline can help you do just that. Download the tip sheet to learn:
- Why you should focus on referral and intake workflows
- Why developing a Significant Change in Condition Policy is important
- What you should be doing to ensure your software is PDGM ready
PDGM is quickly approaching. To prepare, home health agencies will need to make significant changes to their operations. Failure to adapt and respond to these regulatory changes put agencies’ revenue at risk from both a reimbursement and profitability perspective.
PDGM will illuminate the need for strict compliance and accuracy when submitting claims.
Download this free white paper to learn more about the three broad areas agencies must address to successfully manage claims to ensure proper reimbursement under PDGM. The areas addressed in this white paper include:
- Recognizing the twelve clinical sub-groups and unacceptable primary codes
- Identifying common home health codes under each sub-group
- Understanding the steps to prepare coders for PDGM coding
One of the many sweeping changes under the Patient-Driven Groupings Model (PDGM) is the move to 30-day payment periods. Diane Poole, long time industry expert and the Director of Fazzi’s outsourced billing department, has created a position paper to address the implications of this change on billing capacity and cash flow. Specifically, in this position paper you’ll learn:
- Predictions on increased claim submissions by agency size (based on CMS data) and how that impacts the associated workload in your billing department.
- The impact on cash flow from “Half the RAP”.
- How Fazzi will help our outsourced billing clients with these challenges.
Continue reading “How Many More Claims Will You Need to Bill Under PDGM?”
As you probably know, the US Department of Health and Hospitals Office of Inspector General (OIG) recently released a two-part report that reviewed hospice deficiencies across the nation from 2012-2016.
These reports are long, and there has been a great deal of media attention about them. We thought it would be useful to you to have an objective and digestible summary, and so we’re pleased to provide just that. In this paper from Catherine Dehlin, our Director of Hospice Services, you’ll find:
- An objective summary of the two reports released by OIG.
- CMS’ responses to the OIG’s recommendations to CMS.
- Fazzi’s response.
Fazzi’s Findings and Advice about Questionable Encounters: A Complimentary Position Paper
One of the biggest concerns for agency leaders around the Patient-Driven Groupings Model (PDGM) is the issue of submitting claims with primary diagnoses that do not fit into one of the 12 clinical groupings in the payment model.
Read our position paper on this topic to learn:
- Fazzi’s findings about questionable encounters from our own database.
- How Fazzi is helping our outsourced coding clients to minimize questionable encounters.
- Important compliance considerations.
Continue reading “PDGM Readiness: Fazzi’s Answers to Questionable Encounters”