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IL Agency Provides Tips for Pre-Claim Review in Support of the Upcoming Launch in FL

Posted on Wednesday, February 1, 2017 7:20 PM

Among the few agencies in Illinois, Sparta Community Hospital’s At-Home Healthcare was able to maintain a 100% affirmation rate as part of pre-claim reviews.

In order to accomplish this achievement, it has taken about three extra hours of daily work for Cheryl Adams, At-Home’s Administrator.

Illinois agencies continue to work on improving their process and other states including Florida are expecting pre-claim reviews to start later this year (HHL 1/2/17).

Adams recommends agencies take the following steps to survive pre-claim reviews:
• Gather the right info from referral sources
• Designate a specific person to track all the information your agency must compile
• Maintain a standard list of information you need to submit for every claim, and make sure your reviewer keeps that list handy
• Ensure the language in the documentation matches up

Adams’ agency has thoroughly trained clinicians the following:
• Assessing patients accurately
• The staff was trained on documentation of homebound status and the need to ensure wording does not conflict with language used in other documents

Corridor offers a variety of services to help you navigate through the CMS requirements – including:
• Readiness Assessment
• Outsourced Services
• Documentation Review

Call Corridor today for help with Pre-Claim Review. 1-866-263-3795

For the full article, please see the January 30, 2017 Home Health Line Edition.

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