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Category \ Revenue Cycle Management


The release of the Medicare Home Health 2021 Final Rule didn’t come without disappointment and frustration, although the changes are much more subtle compared to the implementation of the Patient-Driven Groupings Model (PDGM) a year ago. While the implementation of … Keep Reading
Home health organizations have a new hurdle from the Centers for Medicare and Medicaid Services’ (CMS) 2021 Final Rule: the no-pay RAP, which introduces penalties for untimely Request for Anticipated Payment (RAP) submissions. Organizations have many questions regarding submission requirements, … Keep Reading
There is tremendous potential to grow a home care organization by expanding care services, and with the market expected to grow to $528 billion by 2026, adding specialty programs should be a top priority. Successfully implementing a program will require … Keep Reading
A tsunami of change came when the Prospective Payment System (PPS), the method of reimbursement since 2000, was replaced with the Patient-Driven Groupings Model (PDGM) in January 2020. Thirty-day billing periods replaced 60-day periods, three areas are now reviewed for … Keep Reading
Home healthcare was turned upside down in 2020, putting the spotlight on telehealth use to complete patient visits. While telehealth visits are not reimbursable, new legislation is aiming for telehealth reimbursement during the COVID-19 pandemic and any future public health … Keep Reading
Healthcare billing can be arduous and claim repricing can be confusing. Put them together without proper training and the result can be a loss of revenue. The use of an easy-to-use revenue cycle management software can help mitigate the claim … Keep Reading
Every quarter, Medicare implements what they call “Dark Days,” a time period when users cannot submit claims through Direct Data Entry (DDE). During the Dark Days, Medicare brings the Common Working File (CWF) offline to install quarterly updates in the … 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

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