Blogs - Tagged: Home Health

Reminder: Home Health Probe & Educate Reviews To Begin Oct. 1

Posted: 09.30.15 | Category: Corridor Solutions

Earlier this year, CMS announced its plans to conduct a Probe and Educate review on home health claims to ensure agencies understand the new certification requirements, specifically, the revised Face-to-Face encounter requirements, effective January 1, 2015.

The reviews will begin October 1, for claims with episodes that begin on or after August 1, 2015. However, the specifics of the review, including the number of claims, length of review, and education methods, have yet to be published.

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ICD-10 Claim Submission Alternatives

Posted: 09.22.15 | Category: Corridor Solutions

CMS has issued a MLN Matters® article for providers claim submission alternatives related to ICD-10 system problems. Providers that are having difficulty completing the necessary systems changes or are having issues with billing software, vendor(s), or clearinghouse(s), may use the following alternatives:

  • Free billing software;
  • Provider internet portals;
  • Direct Data Entry (DDE); and
  • Paper claims.

The article provides details on how providers can use each alternative method for claim submission.

If your organization is having difficulties related to ICD-10 claims submission, please contact us today! Remember, Corridor can do it all! Corridor offers all the ICD-10 solutions your organization needs to be ready!

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CMS ODF Addresses Home Health, Hospice Rules, Hospice Claims Processing

Posted: 08.18.15 | Category: Corridor Solutions

CMS held its Home Health, Hospice & DME Open Door Forum on August 12, 2015.

CMS representatives outlined changes that were included in the final hospice payment rule for FY 2016, which was issued on Friday, July 31. The staff highlighted the following:

  • The final phase-out of the budget neutrality adjustment actor (BNAF) to the hospice wage index;
  • Alignment of the accounting year for the hospice aggregate and inpatient CAPS with the federal fiscal year;
  • Modification of the update factor for the aggregate cap to reflect the annual percentage rate update to hospice (rather than the CPI-U);
  • Imposition of a two-tiered rate of payment for Routine Home Care (eff. Jan. 1, 2016);
  • Implementation of a Service Intensity Add-on for skilled visits in the last 7 days of life (eff. Jan. 1 2016);
  • Use of a single RHC rate from Oct. 1 – Dec. 31, 2015;
  • Clarification that hospices are required to include all diagnoses gathered during the comprehensive assessment on hospice claims (including mental health disorders and other conditions affecting the plan of care) and regardless of whether the diagnoses are related or unrelated to the terminal diagnoses and related conditions.

HOME HEALTH: As part of the home health proposed payment rule for CY2016, CMS is proposing one new quality measure for CY2016 — skin integrity/the percent of patients with pressure ulcers that are new or worsened — to meet requirements under the IMPACT Act. CMS also proposed to raise the pay for reporting threshold:

  • Beginning CY2016 payment determination, CMS is requiring 70 percent timely OASIS submissions for the July 1, 2015 – June 30, 2016 time period
  • July 1, 2016 – June 30, 2017 HHAs must meet an 80 percent timeliness requirement for OASIS submissions
  • July 1, 2017 through June 30, 2018, (and thereafter) HHAs must meet the 90 percent timeliness submission threshold for OASIS submissions.

Click here to read more home health and hospice highlights.

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CMS Announces Medicare Care Choices Model Awards

Posted: 07.20.15 | Category: Corridor Solutions

Today, CMS announced the participants in a new model of care that empowers beneficiaries, their families, and clinicians by providing them greater flexibility in deciding between hospice care and curative treatment. The model is part of a larger effort by HHS to transform the healthcare system to deliver better care, spend money in a smarter way, and put patients in the center of their care to keep them healthy.

The Medicare Care Choices Model provides beneficiaries who qualify for coverage under the Medicare hospice benefit and dually eligible beneficiaries who also qualify under the Medicare hospice benefit to elect to receive supportive care services typically provided by hospice, while continuing to receive curative services.

The model is designed to evaluate whether Medicare and dually eligible beneficiaries would elect to receive supportive care services that are typically provided by hospice if they could also continue to receive curative services. Additionally, the model would test if providing both palliative and curative care concurrently impacts quality of care, as well as patient and family satisfaction.

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U.S. House Of Representatives Passes Health Innovations Bill

Posted: 07.14.15 | Category: Corridor Solutions

The U.S. House of Representatives has passed the 21st Century Cures Act (H.R. 6)) by a vote of 344-77 on Friday, July 10. The legislation contains language of interest to home care and hospice providers and requires CMS to research methods to improve electronic health records, interoperability, and telehealth. The legislation also instructs CMS to report to Congressional committees of jurisdiction on means of expanding telehealth and barriers to its expansion in Medicare, and has a section on ensuring the interoperability of health information. The bill does not make any changes to current telehealth services provided by CMS, as currently written.The legislation has been praised as a “breakthrough initiative,” helping more people get the life-saving treatment they need. Stay tuned to the Corridor blog for updates regarding the status of this legislation.

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