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Category \ Financial


In 2019, the Centers for Medicare and Medicaid Services (CMS) released the CY 2020 Home Health Final Rule, which introduced the new case-mix adjustment methodology, the Patient-Driven Groupings Model (PDGM). This new billing policy went into effect in 2020 and … Keep Reading
Palliative care is a hot topic in healthcare. It not only helps improve a patient’s quality of life through symptom management and goals of care planning, but it also reduces many patients’ revolving door readmissions to the hospital. However, as … Keep Reading
Managing claim payments is an integral but often time-consuming process in the home care industry. Yet with increasing client volumes, an expanding health insurance market and a decrease on reimbursement rates, using claims management tools is a must in order … Keep Reading
Home health documentation has become more complex, evolving over the years to ensure a high standard of care. In the campaign for patient-centered, quality care, governing bodies are now auditing visit documentation to measure quality. The Centers for Medicare and … Keep Reading
We know that cash flow has been affected by many things during 2020, some planned and some unplanned. The Patient-Driven Groupings Model (PDGM), which split the episodic billing into two 30-day periods and changed the reimbursement to diagnostic groups, was … Keep Reading
As organizations continue to adapt to the Patient-Driven Groupings Model (PDGM), one tactic that can be useful is a 30-day review. PDGM has split the home health episode into two 30-day billing periods, which still include both a Request for … Keep Reading
There have been two major actions recently that both relate to medical review of home health records during the public health emergency. In July, it was announced that the suspension of Review Choice Demonstration (RCD) activity due to the current … Keep Reading
The unexpected home health industry development that emerged from the coronavirus (COVID-19) pandemic was the widespread acceptance and use of telehealth visits. With mandatory shelter-in-place orders in most states, performing necessary healthcare visits seemed out of reach. Enter technology. The … Keep Reading
The Centers for Medicare and Medicaid Services (CMS) announced that Review Choice Demonstration (RCD) will be reinstated after an almost four-month pause due to COVID-19. Home health organizations will be required once again to submit claims following the RCD guidelines, … Keep Reading
The year 2020 has brought many changes for home healthcare organizations, starting with the shift toward value-based care in the Patient-Driven Groupings Model (PDGM). This new method of billing, the most significant change in 20 years, requires organizations to bill … Keep Reading
The electronic data interchange (EDI) is one of the most innovative and supportive sets of procedures in our electronic and digitized era. EDI is considered the standard for exchanging documents electronically from one company to another and is used in … Keep Reading
There is a big push in the healthcare industry to get off paper transaction claims and switch to electronic data interchange (EDI) for claim submissions. In order to effectively bill claims to payers requiring electronic transactions, it’s important to find … Keep Reading

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