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PDGM Revenue Impact Analysis

Using historical OASIS and visit information, this analysis assesses the impact of PDGM on revenue, based on past episodes. This data is more accurate than any comparable revenue impact analysis in the industry, since it assesses your data for the last three years and shows questionable encounter codes that will not generate payment under PDGM.

Accessing the PDGM Revenue Impact Analysis: Users with permission to view financial reporting can find this report under the Home or Reports tab.

To give a user this permission, select the Admin tab ➜ Lists ➜ Users. In the Users list, find the appropriate user and select Edit. Select the Permissions tab on the left-side menu. Scroll to the Reporting section of the Permissions screen, and select Access Billing/Financial Reports. Click Save.

The user will then be able to view the PDGM Revenue Impact Analysis in the following locations.

From the Home tab:

From the Reports tab:

As you review your report, it will be immediately apparent how the questionable primary diagnosis encounter codes (which are not payable under PDGM) will financially impact your business. Preparing for these coding practices will have the greatest impact toward achieving success under PDGM.

There are multiple tool tips included in the report to guide you through the information.

Included Episodes

Questionable Episodes

The Questionable Encounter Code metric:

Questionable episodes identify the greatest impact to the business and represent the greatest need for change to be financially successful under PDGM.

Full Episode Pay for DC in 30 Days

The Full Episode Pay for DC in 30 Days metric:

Episode Includes 30-Day LUPA Rule

Full Pay for 60 Days

PDGM Clinical Groupings

Click the video below to watch an overview of the PDGM Revenue Impact Analysis: