Advanced Search

Home Health & Hospice Week

Medical Review:
Beat One Top Denial Reason With 8 Tips
You should check for ADR'd claims daily. With medical review from government contractors ... Read more
OASIS:
Improve OASIS Accuracy -- And Your Rightful Reimbursement -- With 13 OASIS Basics
Watch out for these pitfalls. Is your OASIS assessment process costing your agency paymen... Read more
OASIS:
Follow 7 Rules for OASIS Completion
OASIS expert Judy Adams with Adams Home Care Consulting in Chapel Hill, N.C. offers seven ... Read more
Hospice:
Beware Claims Denials For OBS Hospice Patients
Other claims getting caught up in edits include those for nursing home patients, vascular... Read more
Hospice:
Beef Up Documentation For Dementia Patients With 8 Steps
The more objective measures you use, the better off you'll be in medical review. You'd be... Read more
Tool:
Try Using These Quantifiable Measures To Nail Your Terminal Diagnosis Documentation
Without objective evidence of your patient's decline, you are risking claims denials and y... Read more
Education:
Get Training On 2012 PPS, New HIPAA Requirements, And More
Prepare for the curveballs the prospective payment system update will throw you in the n... Read more
Regulations:
F2F Clarifications To Ease Denials
If your claims were denied for these F2F errors, submit them for reopenings. Now you've g... Read more
Industry Notes:
CMS Adds One More Medical Review Burden
Your utilization may land you in new medical review crosshairs. You may receive even more... Read more
Industry Notes:
DOJ Recovers $2.9B
The Departments of Health and Human Services and Justice have a lot of reasons to ramp up... Read more
Industry Notes:
Beware 'Doc Fix' Cuts
Will Congress give home health agencies a lump of coal in their Christmas stockings? The ... Read more
Industry Notes:
Elderly Population Rises
Who will your client base be in coming years? You can look to a new study by the U.S. Cen... Read more
Industry Notes:
Therapy Caps At $1,880
Caps for outpatient Part B therapy will be $1,880 in 2012, CMS reminds in a MLN Matters a... Read more
Industry Notes:
CMS Billing Cert Coming
Soon you can get billing certification from CMS. In early 2012, the agency will offer a b... Read more
Industry Notes:
Docs Lack Hospice Info
You may have more doctors on your side than you think, if you're trying to boost hospicec... Read more
Industry Notes:
Do This To Get Another RA
It won't do you any good to request a copy of a remittance advice if it's within 90 days ... Read more
Industry Notes:
Catch New OIG Training
You can tune in to the OIG's website each week to watch a new video and audio podcast on ... Read more
Industry Notes:
HHA Fraud Nets Jail Time
Participants involved in a home care scam are facing years of jail time. Miami-area physi... Read more
Industry Notes:
Ohio Chain Makes Big Buy
An Ohio chain has made its biggest acquisition to date. Kenwood-based Home Care by Black ... Read more
Medical Review:
Don't Let Top Denial Reasons Shoot Down Your Claims
Homebound status, lack of skilled need common reasons for denials. If you don't thoroughl... Read more
OASIS:
Use Your OASIS To Pinpoint Medical Review Red Flags
Functional domain scores, diagnosis items can lead reviewers to your weak spots. One way ... Read more
Tool:
Know When Your Patients Qualify For Home Care -- And When They Don't
Use this checklist from one HHH MAC to guide your eligibility assessments. Medical review... Read more
Compliance:
Hospices Serving Nursing Home Patients Brace For 2012 Scrutiny
OIG work plan for next year throws spotlight on this care setting. In a report earlier th... Read more
Prospective Payment System:
Case Mix Changes Take Effect On M0090 Date
The 2.3 percent cut will hit a bit later. Don't expect to have an episode's worth of lag ... Read more
Industry Note:
DME Bidding Areas Will Reach 100 By 2013
Bidding registration is now open. Chances are your patients' choice of durable medical eq... Read more
Industry Note:
Home Health Copay Threat Still Looms
Keep an eye peeled for developments in Washington regarding the so-called "doc fix." Indu... Read more
Industry Note:
Use New ABN Quick Glance Tool To Make ABN Calls
You've got newly revised instructions that go with the home health advance beneficiary no... Read more
Industry Note:
Make Hospice Discharge Code Change Jan. 1
Starting Jan. 1, you shouldn't use occurrence code 42 on your hospice claims when the ben... Read more
Industry Note:
CMS Lifts One F2F Documentation Requirement
Ideally, you shouldn't be seeing any more claims denials when your hospitalized patient's... Read more
Industry Note:
MA Enrollees Increase
If you feel like your managed care headaches continue to grow, it's likely because Medica... Read more
Industry Note:
Home Health May Dodge Medicaid RACs' Scrutiny
The Medicaid RACs will soon make their debut. "Absent an exception, States will be requir... Read more
Industry Note:
Note LCD Denial Change
You'll get a little Christmas present from HHH MAC subcontractor National Government Serv... Read more
Industry Note:
FBI Raids TX Agency
The fraud-fighting hammer appears to be dropping on an Alamo, Texas HHA. Rio Home Care wa... Read more
Industry Note:
Newspaper Profile Gives Houston HHAs Bad Rap
Meanwhile, HHAs in Houston, Texas are getting a black eye in the press, thanks to a Houst... Read more
Documentation:
Use These 5 Guidelines For Audit-Proof Record Corrections
Documentation clarifications can be a big help -- if you use them wisely. With the ... Read more
Medical Review:
Avoid Late Entry Red Flags
When does a clarification hurt instead of help? If you correct or add to every medical r... Read more
HIPAA:
Providers Get A Breather On 5010 Until March
Evaluate your options for 5010 compliance. Sweating over the fact that your 5010 standar... Read more
Billing:
Know The Rules For 5010 Address Field
Warning: Your contractor could be issuing incorrect information. If you're sticking to y... Read more
Budget:
One Budget Threat Down, One To Go
Don't count a copay out yet. Many home care providers gave thanks when the so-called con... Read more
Industry Note:
OIG Hits Therapy, Supplies In New Report To Congress
Not surprisingly, hospice-nursing home relationships also are on the watchdog agency's hi... Read more
Industry Note:
Obama Nominates Former Nurse For CMS Top Spot
New leadership for CMS is on deck for 2012. Centers for Medicare & Medicaid Services ... Read more
Industry Note:
New Report Gives Advice On Boosting Your Outcomes
Are you looking for ideas to reduce your hospitalization numbers? If so, tune into a free... Read more
Industry Note:
Benchmark Your Hospice LOS With These Stats
Wondering how your hospice average length of stay stats fit in with your peers? Now you c... Read more
Industry Note:
CMS Changes Listing Format For Ordering Physician File
You may have to tweak your procedures for checking whether your referring physicians are ... Read more
Industry Note:
Help SNFs Code Hospice On MDS With These Tips
If you're a hospice provider serving nursing home patients, you can help those facilities... Read more
Industry Note:
New Study: Home Care Boosts Outcomes, Cuts Costs
A new study may help sway policy- and lawmakers toward boosting home care. Findings from ... Read more
Industry Note:
Gentiva Expects 'Difficult Reimbursement' Time Ahead
News of debt restructuring has sent stock prices for Gentiva Health Services Inc. up. The... Read more
Industry Note:
Maxim Staff Draw Jail Time, Home Confinement For Fraud
Even if you aren't the brains of a large scale fraud scheme, you can still get some stiff... Read more
Regulations:
Final Rule Changes To F2F Fall Short Of HHAs', Docs'Wishes
Documentation will stay complicated for the troublesome face-to-face requirement. You can... Read more
Compliance:
It's The Season For Giving -- But Not Too Much
Keep OIG guidance in mind when deciding on your holiday gift list. Under the face-to-face... Read more
Fraud & Abuse:
Just Say No To Giving Most Gifts To Patients
It may be better to give than to receive, but keep costs low. You'd love to spread some h... Read more
Hospice:
Don't Give Extra Hospice Services To Nursing Homes, Even When They Ask
The OIG will be watching. The excuse of "everybody's doing it" won't hold water when the ... Read more
Documentation:
Make Sure These Documents Are In Your Nursing Home Patients' Files
Plus: Help nursing homes use the MDS to identify residents who need hospice services. Fed... Read more
Industry News:
Should Home Care Providers Be Thankful For The Super Committee?
Copays will drive up institutional costs, trade groups warn. Will they or won't they? At ... Read more
Industry News:
There's Still Time To Observe Home Care Month
Have you let home care month nearly pass you by without marking the occasion? It's not to... Read more
Industry News:
If You Haven't Tested 5010 Yet, Start Making Back-Up Plans
Ready or not, you've got less than 45 days until 5010 implementation is mandatory. Effec... Read more
Industry News:
Medicare's Fraud-Fighting Is Inadequate, OIG Says
Poor data is keeping Medicare's fraud contractors from overseeing you like they should. S... Read more
Industry News:
Check Out 2 Wage Index Corrections For 2012
You might need to double-check your wage index that takes effect Jan. 1. CMS has issued c... Read more
Industry News:
Check This List Twice For Revalidation Requests
Can't quite figure out if you're on Medicare's enrollment revalidation list? CMS says tha... Read more
Industry News:
New Regional Chain Launches In Southeast
New "platform entity" Partners Healthcare Group has launched its campaign to acquire home... Read more
Industry News:
Say Good-Bye To Second Overpayment Demand Letter
If you owe Medicare money, don't expect your contractor to tell you twice. CMS is discon... Read more
Industry News:
Assess For Cognitive Issues When Stroke Is A Risk
If your patients have risk factors for stroke, particularly high blood pressure, you need... Read more
Hospice:
Fend Off Denials -- Or Worse -- With These 8 Tips To Improve Your Documentation
Tip: Focus less on what your staff does and more on what your patient needs. At least 10... Read more
Contractors:
Beware These Eyes Looking Over Your Shoulder
States are looking at hospice-nursing home relationships. It's not just intermediaries an... Read more
Compliance:
'Predictive Modeling'Now Targets Claims For Review
Will the new number crunching put you in Medicare's crosshairs? Don't ever accuse CMS of ... Read more
Human Resources:
5 Interviewing Secrets You Need To Know
Use these tips to determine whether an applicant's right for the job. Do you understand w... Read more
Industry Note:
Publicly Traded HHA Chains Report Massive Losses
One company bucks the trend with a modest sprofit for the third quarter. More fallout fro... Read more
Industry Note:
Feds Execute Search Warrants In Michigan Fraud Case
The owner of four Detroit-area HHAs is facing Medicare fraud charges to the tune of $30 m... Read more
Industry Note:
Requirements For Hospice Quality Reporting Out
If you want to submit your hospice quality data during Medicare's voluntary reporting per... Read more
Industry Note:
CMS Delays Revalidations For PECOS-Enrolled Providers
Home care providers have won a little breathing room on their Medicare revalidations ... Read more
Industry Note:
Recertify Your DDE User ID Or Face Lockout
Add one more item to this month's to-do list, if your contractor is National Government S... Read more
Industry Note:
Use This Tip To Avoid Claims Returned With Code 31313
Seeing claims returned with reason code 31313? Check the Release of Indicator (RI) field ... Read more
Industry Note:
Regional Chain Buys Virginia Private Duty Provider
Regional chain CareSouth Health System Inc. is acquiring private duty provider Family Car... Read more
Industry Note:
Look In Unexpected Places For Start-Up Capital
If you're looking for start-up capital, you may want to pursue non traditional funding so... Read more
Industry Note:
Texas Home Care Nurse Sentenced To Prison
Keep a close eye on your visiting staff, or you may find yourself wrapped up in a federal... Read more
Reader Question:
State Laws Are Paramount When Dealing With Collections
If you bill your patients directly for services, copays, etc., note this expert advice. Q... Read more
Prospective Payment System:
2.3% Pay Cut Hits Freestanding For-Profits Hardest In 2012
Case mix changes reduce reimbursement rates for high-therapy episodes. The home care indu... Read more
Diagnosis Coding:
Don't Let These Coding Deletions Make You Tense
Capture those 3 case mix points with better coding. You should hone your coding of condit... Read more
Regulations:
HHAs Make Slight Gains In F2F, Therapy Requirements
Also read up on these CAHPS, ICD-10, and homebound definition changes. In addition to pay... Read more
Industry Note:
Looming Medicare Cuts From Super Committee Threaten Home Care
Budget-cutting efforts pick up steam as Thanksgiving deadline approaches. Home care provi... Read more
Industry Note:
You Can Ignore These Ownership Questions On New Enrollment Form
When you're filling out the new 855A form, there are a few sections you can skip. "The Ju... Read more
Industry Note:
Say Good-Bye To Last Holdout For Late Charges
Get ready to make a hospice billing change this spring. For April 1 or later services, ho... Read more
Industry Note:
Part B Deductibles, Premiums Decrease In 2012
Your patients are getting good news about their Medicare bills. Part A premiums will incr... Read more
Industry Note:
Avoid These Hospice Technical Denial Hot Spots
Don't let technicalities result in your hospice claims getting denied. The problem: One t... Read more
Industry Note:
NHIC Providers Should Use This Software Patch
If NHIC is your HHH MAC and you use PC-ACE Pro 32 billing software, be sure to heed the co... Read more
Industry Note:
Head Off Claims Delays With New MAC Addresses
Just when you've gotten used to sending your documents to one mailing address for new HHH... Read more
Industry Note:
After Senate Therapy Report, 'Big 4' Co. Reports Huge Loss
The near future is looking bleak for publicly traded home care companies. The first of th... Read more
Industry Note:
MO Provider Settles Medicaid Fraud Charges For $130K
A St. Louis-area home care provider, Midland Empire Resources for Independent Living in S... Read more
Reimbursement:
Use These 10 Vital Tips For Billing Success
Do your billers' job descriptions really match what they're doing? With your Medicare mar... Read more
Information Technology:
Don't Let Your Cash Posting Procedures Open The Door To Losses
Research every adjusted claim for accuracy, expert urges. If you let your billing softwar... Read more
Billing:
Keep Your Billing On Track With These Crucial Benchmarks
You should run this vital billing report weekly. Home health agencies that fail to keep t... Read more
Enrollment:
Avoid These Revalidation Goblins
Tip: Failing to send in your CHOW information ASAP could haunt you. CMS and its contracto... Read more
Diagnosis Coding:
Prepare for ICD-10 Conversion With 2 Simple Steps
Know your anatomy and physiology if you want a quick transition. It's not too early to st... Read more
Industry Note:
HHAs Get Answers To Therapy Reassessment Questions
Should you bill with no assessment? Although Medicare's therapy reassessment requirement ... Read more
Industry Note:
CMS Falls Down On Reinstatement Hearings
Expect hearings over Medicare suspensions to get tougher in the wake of an Associated Pre... Read more
Industry Note:
Missing Hospice F2F Is Your Responsibility
You are on the hook to provide free care if your hospice patients' face-to-face requireme... Read more
Industry Note:
Plan On Adjustments For Flu Vaccine Claims
Pay attention to your claims for flu vaccinations, or you may be losing Medicare reimburs... Read more
Industry Note:
RN Pay Rises In 2011
If you didn't increase your nursing salaries in 2011, you're out of step with the industr... Read more
Industry Note:
Hospice Discharge Planning Required Without Pay
Medicare may not pay for discharge planning when a hospice patient is no longer terminall... Read more
Industry Note:
Transfer Denials May Rise
Checking the Common Working File for a patient's Medicare history is more important than ... Read more
Industry Note:
More HIPAA Audits On Deck, Lawyers Warn
Get ready for OCR to roll with serious HIPAA audits. The HHS Office for Civil Rights, whi... Read more
Industry Note:
Hospice Owner Indicted
Hospices aren't immune from the feds' crackdown on Medicare fraudsters. Matthew Kol-odesh... Read more
Industry Note:
Show-Me State Provider Settles Fraud Charges For $600K
Delmar Gardens Private Services in Chesterfield, Mo. has settled Medicaid fraud charges f... Read more
Survey & Certification:
Top Survey Changes You Can't Afford To Miss
Appendix B may not be on the CMS SOM website, but it's still in effect. Your next Medicar... Read more
Training:
9 Tips To Ace The New Survey Interview Requirement
Get out of the office to practice your employees' survey interviews. If interviews of you... Read more
Hospice:
Ready, Set, Elect Your Hospice Cap Method
Choices differ for this year versus next year. At least one HHH MAC is ready to accept yo... Read more
Human Resources:
Run A Successful Suggestion Program
You know your workers have good ideas, but the suggestion box is always empty. Get them t... Read more
Industry Note:
Keep Your Eye On The Congressional Super Committee
Fate for home care copay may be close at hand. Influential legislation to cut your Medica... Read more
Industry Note:
Incorrect G Code Adjustments, National Provider Identifier Suspensions Hound Home Care Providers
A few different claims system glitches might have held up your claims, but those problems... Read more
Industry Note:
Obama Administration Drops Long-Term Care Insurance Initiative
Don't count on the CLASS Act to increase your home care census any time soon. In a letter... Read more
Industry Note:
New Hospice ABN Required By Jan. 1
Beginning Jan. 1, hospices must use the new 2011 version of their Advance Beneficiary Not... Read more
Industry Note:
Grouper, HAVEN Updates Due To ICD-9 Codes Posted
You should have begun using updated ICD-9 diagnosis codes this month, and your grouper so... Read more
Industry Note:
OIG Shines Spotlight On $1.2M Hospice Was Overpaid
More evidence that the feds are putting hospices in their oversight crosshairs: a new rep... Read more
Industry Note:
Don't Substitute Therapy Asst. For Home Health Aides
Don't be so quick to substitute a therapist assistant for a home health aide when your sc... Read more
Industry Note:
Long-Term Care Giant Makes Home Care Buy
Long-term care giant Kindred Healthcare Inc. has made another home care acquisition, this... Read more
Industry Note:
Reimbursement, Regulatory Woes Cause HH Closures
Tighter Medicare and Medicaid reimbursement is causing some home care providers to close,... Read more
Fraud & Abuse:
Expect Therapy Pay Changes In Wake Of Senate Report
Senate investigation blasts 3 of the 'big 4' companies for gaming the system. Regarding h... Read more
Know Your Facts:
Publicly Traded Companies Changed Therapy Utilization In Response To Reimbursement
One chain saw 10-therapy-visit episodes drop from 20 to 7 percent in one year. Law- and p... Read more
Compliance:
OIG Ramps Up HHA Oversight For 2012
OIG work plan adds 5 new HHA topics to 4 existing ones. Monitoring home health agencies w... Read more
Industry Note:
NGS To Take Over HHH MAC Contract In Jurisdiction 6
NGS is currently subcontractor in the J6 area. Home health agencies who have NHIC as thei... Read more
Industry Note:
Hospice Cap Selection Deadline Up In The Air
Give your hospice cap methodology selection careful thought, because doing nothing may be... Read more
Industry Note:
RACs Make Money For Returning Money Too
A new CMS report reveals the results of Recovery Audit Contractors nationwide, and the nu... Read more
Industry Note:
Discharge Hospice Patients When F2F Is Missed
CMS has put some of its face-to-face billing guidance for hospices in a more official for... Read more
Finance:
Home Care Companies Stand By Their Practices
The home care companies that are the subject of the Senate Finance Committee's report are ... Read more
Enforcement:
LHC Group Pays $65 Million To Settle Lawsuit
National chain enters into CIA with OIG. It doesn't have to be your own employee who dra... Read more
Industry Note:
Beware This Cash Flow Hiccup Under CGS
Don't think a bump in your cash flow from last week will continue into this week. The Ken... Read more
Industry Note:
CMS Adds Requirements Before HHAs Are Certified
Newly enrolling providers will have a few more hoops to jump through before obtaining Med... Read more
Industry Note:
Hospice Quality Reporting Info Available Online
You can take a look at the proposed forms for the voluntary hospice quality reporting per... Read more
Industry Note:
HIPAA Breach Comes From Government Payor This Time
HIPAA breaches don't always come from providers. Tricare, the massive U.S. military insur... Read more
Industry Note:
Tip: Educate Docs' Billers To Boost Hospice Referrals
You may boost your hospice referrals if you help your referring physicians learn to navig... Read more
Industry Note:
Nurses Plead Guilty, Receive Sentence In Fraud Schemes
The feds continue to rack up fraud convictions of home care providers in Miami. An RN for... Read more
Medical Review:
Check Your Docs Carefully Or Risk Losing Reimbursement
CMS's fraud data project catches episodes ordered by ineligible physicians. If you're lax... Read more
Reimbursement:
Head Off Doc-Related Denials With These 5 Steps
Get friendly with your physician databases. You won't have any financial recourse if Medi... Read more
Budget:
MedPAC Recommends Big Cuts To HHA, Hospice Rates
Copays, pay updates and hospice in SNFs feature in advisory body's latest suggestions. Ho... Read more
Billing:
Vendor Won't Be Ready For 5010? Get Claims In Before 2011 Ends, CMS Advises
Plus: Could you qualify for a 5010 exemption? Do you know what to do if your vendor isn't... Read more
Hospice:
Use This New Hospice Cost Report Form
There are more changes in addition to the instructions issued earlier this summer. Get re... Read more
Industry Note:
Respond To CAHPS Pay Reduction Quickly
Letters about 2 percent pay reduction in 2012 went out in September. The clock is ticking... Read more
Industry Note:
2 States Expand Patient Privacy Breach Notification Requirements
If you live in certain states, you may need to tighten up your patient privacy practices.... Read more
Industry Note:
Beware Claims Returned With Reason Code 12201
Providers having trouble with their roster billing again aren't alone. Providers are seei... Read more
Industry Note:
Use This Strategy To Tackle Managed Care Penetration
If you're wondering how to tackle the rise of Medicare managed care penetration, you can ... Read more
Industry Note:
Tune In For Info On Enrollment Revalidation
Trying to figure out exactly what you'll need to do under Medicare's new enrollment reval... Read more
Industry Note:
End-Of-Life Discussions Don't Impact Survival, Study Says
Open dialog about hospice use and other end of life issues is getting a boost from a new ... Read more
Industry Note:
National Chain Pays $160K To Settle ADA Lawsuit
Maxim Healthcare Services is getting more bad press, this time due to a labor law lawsuit... Read more
Industry Note:
Hospice Ponies Up $36K Fine For Excluded Employee
Check and double check your employees for exclusion from federal health care programs. Th... Read more
Industry Note:
Miami Fraud Ring Bust Nets 12 More Guilty Pleas
The guilty pleas keep rolling in in the massive fraud case revolving around Miami home he... Read more
Patient Privacy:
Focus On Portable Device Protection In Your HIPAA Compliance Plan
Home care providers face special privacy risks. With HIPAA enforcement looking to ramp up... Read more
Compliance:
Take These 6 Steps To Shore Up Your HIPAA Compliance
The majority of home care providers are out of compliance, experts believes. Smart hom... Read more
HIPAA:
Remind Home Care Workers Of Facebook Rules
Employees have a right to use social media, but must protect identifiable patient informa... Read more
Budget:
President Obama Proposes Home Health Copayment
Expect a fight to avoid a $100 copay for nonhospitalized patients. You may find a lot of ... Read more
Enrollment:
Your PECOS Edit Concerns May Be Over
At the very least, claims rejections from PECOS edits should be greatly reduced when they... Read more
Industry Note:
RAC Audits Will Impact Medicaid Claims Jan. 1, CMS Says
Delays have given you more time to prepare. You've benefited from several delays to Medic... Read more
Industry Note:
Medicare Requires Electronic Funds Transfer With Revali-dation
If you still receive Medicare payments via paper, don't expect that to last long. "Existi... Read more
Industry Note:
Understand This Therapy Reassessment Loophole
You'll be off the hook for a therapy patient's 30-day reassessment if the patient is in t... Read more
Industry Note:
HIPAA Problems Abound
Just because HIPAA breaches don't make the nightly news doesn't mean they aren't happenin... Read more
Industry Note:
Expect To Serve More Managed Care Patients
Don't be surprised to see more Medicare Advantage managed care patients on your rolls in ... Read more
Industry Note:
Overpayment Logging Delays Creates Confusion
Don't freak out if you get a second overpayment letter from HHH MAC subcontractor Nationa... Read more
Industry Note:
Keep An Eye On 2012 Vaccination Pay Rate
With flu season nearly upon you, it may be time to brush up on your vaccination reimburse... Read more
Industry Note:
CMS Pushes Back First Payment Bundling Deadline
Introducing bundling across provider types for Medicare payments may take a bit longer th... Read more
Industry Note:
Authorities Pound Medicaid Providers On Fraud
Authorities continue to pound Medicaid home care providers with the anti-fraud hammer. In... Read more
Industry Note:
Beware Falls Problems For Patients With Poor Eyesight
You should consider putting your patients who have diminished eyesight on the watch list ... Read more
Reimbursement:
Get Ready To Defend Your LUPA Claims
Appealing LUPA claim denials is costly. If you haven't seen extra scrutiny of your LUPA c... Read more
Medical Review:
Use These 5 Tips To Combat LUPA Denials
Do your LUPA stats stick out in comparison to your peers? With at least one HHH MAC focus... Read more
Fraud & Abuse:
National HHA Chain Settles Fraud Charges For $150 Million
Maxim Healthcare Services billed for services not rendered, among other problems. It's no... Read more
Patient Privacy:
Avoid These HIPAA Land Mines For Your Clinicians' Cell Phones
Are staffers communicating via text or mobile phone? Make sure they're HIPAA-compliant. M... Read more
Audits:
Beware These Other Medical Review Topics
Make sure your low case mix weight claims are well defended. Don't assume high-dollar cla... Read more
Enforcement:
Strike Force Takedown Targets 16 Home Care Defendants
Referrals prove a key point of enforcement in this record-breaking sweep. Home care opera... Read more
Industry Note:
HHAs, Hospices Most Satisfied With Medicare Contractors
Appeals are the least-approved RHHI service. The highest-scoring regional home health int... Read more
Industry Note:
Home Care Heroes Step Up In Hurricane Irene
Although the home care industry hardly needed it, HHAs and hospices got another reminder ... Read more
Industry Note:
Be Wary Of Falls For Patients With Vision Trouble
You should consider putting your patients who have diminished eyesight on the watch list ... Read more
Industry Note:
Don't Waste Money Failing To Respond To ADRs
If you're receiving claim denials with reason code 56900, you're throwing your money away... Read more
Industry Note:
Download The New HH PPS Pricer
You can download a new version of the Home Health PPS PC Pricer at www.cms.hhs.gov/PCPric... Read more
Industry Note:
More HIPAA Enforcement Could Be Around The Corner
The HIPAA fines and settlements you've seen may be just the tip of the iceberg. HHS Secre... Read more
Referrals:
Apply This Expert Advice To Market Smarter And Grow Your Business
Sending out a nurse with donuts just isn't enough anymore. If you aren't employing dedica... Read more
Compliance:
Steer Clear Of Non-Employee Marketers
Don't risk long-term compliance for short-term gains in referrals. Once you've decided to... Read more
Marketing:
What's In A Name? 'Liaison' Covers Lots Of Marketing Territory
There are two main types of liaisons, marketing expert explains. What type of marketing s... Read more
Therapy:
Watch Out For Outpatient Therapy Payment Pitfalls
Pay attention to these reimbursement-threatening developments. Home health agency payment... Read more
Industry Note:
Turn To This Resource For F2F Answers
You might not always like what the HHH MAC is telling you, however. Don't waste your time... Read more
Industry Note:
Feds' Health Care Fraud Prosecutions On Track To Rise 85% This Year
It's not just your imagination; health care fraud busts are way up this year. Data obtai... Read more
Industry Note:
CMS Issues Instructions On How To Bill Claims Spanning The ICD-10 Implementation Date
One more piece of the ICD-10 puzzle is now in place. The Centers for Medicare & Medic... Read more
Industry Note:
Suppliers Have 40 Days To Repay Overpayments Before Recoupments Kick In
If you've ever wondered about the logic behind Medicare's overpayment recovery system for... Read more
Industry Note:
Look At Your CAHPS Data Submission Reports
Most agencies are now participating in the Home Health Consumer Assessment of Healthcare ... Read more
Industry Note:
Chiropractors Can't Order Home Care, CMS Reminds
Don't let a mistake on Medicare's part mess up your physician referrals. According to an ... Read more
Industry Note:
New Hospice Election Statement A Must If You Miss F2F
Don't believe everything you hear when it comes to face-to-face encounter requirements fo... Read more
Industry Note:
Don't Neglect Enrollment Changes During Revalidation
Submit your usual enrollment changes timely, or you'll be sorry. "The Medicare provider e... Read more
Industry Note:
Use These Free Education Tools To Master Billing Topics
Looking for help with your HHA or hospice billing? New HHH Medicare Administrative Contra... Read more
Industry Note:
Gentiva Plans To Shed Remaining CareCentrix Stake
Gentiva Health Services Inc. plans to unload its stake in managed care benefit company Ca... Read more
Reader Question:
Documentation, Certification Key To F2F Hospitalist Change Coming Jan. 1
2012 rule proposes to lift F2F load largely off hospital physician's shoulders. Question:... Read more
Face To Face:
OASIS Requirements May Make Your F2F Burden Heavier
Confusion persists over how to handle a missed encounter and the start of care. A seeming... Read more
Regulations:
Keep Your Therapy Reassessment Rules Straight
PPS proposed rule and illegal alien patients also addressed in latest Open Door Forum. Do... Read more
Hospice:
Vital Hospice Instructions Coming From Medicare Soon
Forthcoming guidance will address hospice cap methodology, quality measure reporting. Cha... Read more
Durable Medical Equipment:
Round 2 Of DME Bidding Adds Nationwide Diabetic Supplies
Program expands to 91 metro areas in 2013. If your patients aren't affected by competitiv... Read more
Audits:
4 Strategies To Stop RACs From Catching You By Surprise
It's time to improve your billing, documentation. The RAC program is coming to Medicaid, ... Read more
Industry Note:
Medicare Introduces Payment Bundling For Post-Acute Care
The program is voluntary -- for now. CMS has unveiled a payment methodology home car... Read more
Industry Note:
Don't Rush Revalidation
You soon may need to submit your enrollment information again to get revalidated under ne... Read more
Industry Note:
Payment System Glitch Returns Claims Incorrectly
Look over your returned claims carefully if they've been RTP'd with reason code 31018 or ... Read more
Industry Note:
USA Today Focuses On Hospice Fraud, Lobbying
The hospice industry is getting a bad rap in a widely read national newspaper. USA Today... Read more
Industry Note:
Zero In On Patients' Infection Risks
If you want to protect your workers and patients against infections, you may want to chan... Read more
Industry Note:
Beware These Therapy Billing Pitfalls Under Part B
HHAs that run a Part B outpatient therapy business that goes into patients' homes should ... Read more
Industry Note:
Instructions For ICD-10 Billing Imminent
Watch for instructions to come soon on billing for claims that cover the ICD-9-to-ICD-10 ... Read more
Industry Note:
Providers Eye Congressional Super Committee For Cuts
The so-called super-committee appointed to propose budget cuts has begun work on its task... Read more
Industry Note:
Physician Pleads Guilty In HHA Fraud Scheme
It's not just the HHA-related staff that are going down in a $25 million fraud scheme all... Read more
Industry Note:
FBI Search In Minnesota Results In Fraud Charges
When the FBI turns up to search your workplace, it rarely goes well. Earlier this year th... Read more
Hospice:
Hospice Claims For Nursing Facility Residents Under Fire
Hospices with lots of nursing home patients are suspicious, new OIG report says. You may ... Read more
Know Your Facts:
Number Of Hospice Benes In Nursing Facilities Grew 40%
For-profits receive more reimbursement per beneficiary than non-profits. Here are the 200... Read more
Fraud & Abuse:
HHAs Should Tread Carefully With ALF Relationships
OIG may turn its focus on this compliance trouble spot next. Home health agencies may thi... Read more
Industry Note:
Prepare Your Execs, Employees For Govt Investigators
Sticking your head in the sand won't help if you're the target of a probe. Don't wait unt... Read more
Industry Note:
Industry Eyes Committee Members In Charge Of Budget Cuts
The home care industry appears to have a few supporters on the so-called super committee c... Read more
Industry Note:
Medicare Furnishes Fraud Prevention Toolkit For Beneficiaries
If you don't communicate clearly with your patients, you may find yourself reported for fr... Read more
Industry Note:
Turn To DDE For Online Claims Correction, MAC Tells Providers
Relying on your MAC's customer service reps to correct your online claims isn't likely to ... Read more
Industry Note:
Take Responsibility For Your 5010 Compliance
Don't count on your vendor to see you through the 5010 transition that starts Jan. 1. &nbs... Read more
Industry Note:
Kick-Start Your ICD-10 Prep With Podcasts
Have you been putting off thinking about the transition to ICD-10 diagnosis coding? Now yo... Read more
Industry Note:
Know Which G Codes Cover LPNs -- And Which Don't
HHAs confused about how to report LPN visits with G codes can look to new HHH MAC CGS for ... Read more
Industry Note:
Learn Retention Lessons From Top-Rated Employer
If you're having trouble retaining employees, you may want to take a page from one New Jer... Read more
Industry Note:
Kindred Ups West Coast Home Health Presence
Long-term care giant Kindred Healthcare Inc. continues to expand its home care presence on... Read more
Industry Note:
Former Gentiva Unit Inks New Managed Care Deal
Home care benefit management company CareCentrix Inc. has inked a deal with Aetna to be th... Read more
Reader Question:
You Don't Have To Enroll In PECOS -- But You May Want To
CMS spokesperson clarifies agency's online enrollment policy. Don't believe everything yo... Read more
OASIS:
Brush Up On This OASIS Item Before It Costs You
New guidance could change your response to case mix question on ambulation. Accurately sc... Read more
Hospice:
Report Nursing Home Crimes Or Violate Regulations
Watch out for retaliation against your hospice if an employee reports. Hospices should get... Read more
Compliance:
Master SNF Reporting Requirement With These 6 Tips
Craft your policies & procedures carefully. Use these expert tips to make sure you're... Read more
Human Resources:
Combat Defensiveness When Addressing Employees' Problem Behavior
Use clear, strong communication to keep your troublemakers on track. You may have a worke... Read more
Regulations:
New F2F, Therapy Requirements Drain HHAs’ Profits
LHC, Gentiva report earnings decreases for their latest quarters. The hits to earnings th... Read more
Industry Note:
Document Your Transfer Contacts Or Risk Losing Out
New form required from one MAC. If you fail to contact your patient's previous home healt... Read more
Industry Note:
CMS Touts Physician P4P Program
A successful Medicare demonstration project may put home care providers one step closer t... Read more
Industry Note:
Check Out Clarified Hospice Billing Instructions For Discharges
You need to use the correct codes on your hospice claims for discharged patients, or thei... Read more
Industry Note:
HHAs' Quality Data Posted On New Medicare Website
Medicare beneficiaries now have an easier way to find you -- and check up on your qu... Read more
Industry Note:
DME Item Tops One RAC's Audit Collections List
A durable medical equipment item is the top issue in Region C under RAC Connolly Inc., so... Read more
Industry Note:
Tune In To CMS Calls For OIG Compliance Topics
Want to learn more about the HHS Office of Inspector General's compliance focus on hospic... Read more
Industry Note:
Get Ready For Medicare Revalidation Request
If you haven't had to revalidate your Medicare enrollment yet, you will soon. "Between no... Read more
Industry Note:
Home Care Nurse Convicted Of Fraud Gets 10 Years In Jail
A Miami-area home care nurse convicted of health care fraud related to diabetic home heal... Read more
Industry Note:
Hundreds Of Providers Test 5010 Format
Providers that aren't testing their 5010 transactions may be falling behind. Back in June... Read more
Reimbursement:
Hospice Payment Rates To Increase 2.5% In October
Plus: Soon you'll need to make your hospice cap calculation decision. Unlike home health ... Read more
Hospice:
Hospice Quality Reporting Starts In January
The two initially reported measures are just the beginning, CMS says. The hospice 2012 wag... Read more
Regulations:
Know New Hospice F2F Ropes Or Risk Compliance, And Pay
CMS clarifies what to do when the face-to-face requirement isn't fulfilled. Complying wit... Read more
Fraud & Abuse:
Feds Turn Up The HEAT On Home Care Fraudsters
Four case studies show the newly expanded strike force is on the prowl. The rate at which... Read more
Industry Note:
Debt Deal Puts Threat Of Cuts On The Horizon
You could get an unwelcome Christmas present under newly enacted compromise. Home care pr... Read more
Industry Note:
F2F Takes Its Toll Already
Face-to-face encounter requirements are hurting home health agencies' bottom lines, inclu... Read more
Industry Note:
In 2013, Hospitals To See Pay Cut For Readmissions
The proposal that would give hospitals an incentive to line up home care for their discha... Read more
Industry Note:
New Enrollment Form Confuses Providers
When you need to fill out an 855A form for enrollment or revalidation, you'd be smart to ... Read more
Industry Note:
Keep An Eagle Eye Out For DDE Access Letter
If you miss this important letter, you could get shut out of the Medicare claims system. ... Read more
Industry Note:
MAC: You're Responsible For Physician Documentation
Don't think you're off the hook for medical record submission if those records are at you... Read more
Industry Note:
Find New ICD-9 Code Titles With This Resource
If you're trying to get a handle on the new ICD-9 codes that take effect Oct. 1, you have... Read more
Industry Note:
Resolve Your Most Common Billing Errors With CGS Tool
Having a hard time figuring out why your Medicare claim got returned or rejected? Check o... Read more
Industry Note:
Now's The Time To Update Your Emergency Plan
You'd better put updating your emergency preparedness plan on your priority list if you l... Read more
Industry Note:
Are You Meeting Both Therapy Reassessment Deadlines?
Don't think you can keep billing for therapy if you meet one therapy reassessment require... Read more
Face-To-Face:
PPS Rule To Ease F2F Burden, But Major Challenges Remain
Don't expect substantial changes to the face-toface requirement from CMS. One face-to-face... Read more
Medicaid:
Medicaid F2F Requirement To Hit Next
If your state hasn't adopted a Medicaid face-toface requirement yet, it will soon. Just w... Read more
Diagnosis Coding:
Expect Scores Of New Case Mix Codes In 2012
Watch for PPS final rule to pin down final coding changes. If you thought the 2012 ICD-9 ... Read more
Regulations:
Rule: Don't Forget That Medicare, Medicaid Are Very Different
For instance, homebound requirements are actually prohibited in Medicaid. In addition to ... Read more
HIPAA:
Provider Pays $865,500 Fine For HIPAA-Violating Peek
You don't need celebrity patients to learn from this HIPAA mistake. If you knew Brad Pitt... Read more
Industry Note:
Fewer HHAs To Receive Bonuses From P4P Demo's 2nd Year
Half of the participating regions failed to generate program savings. All the hard work p... Read more
Industry Note:
CMS Speeds Regulations For Bundling Medicare Payments.
Having your Medicare payments bundled into hospital reimbursement may happen sooner than ... Read more
Industry Note:
Try This Work-Around For Vaccination Billing Glitch
As flu season approaches, try this workaround for a glitch with the Medicare claims syste... Read more
Industry Note:
RAC Adds One More Home Care Review Topic
One of the Recovery Audit Contractors has secured CMS approval of another home carerelate... Read more
Industry Note:
Don't Forget Compliance With ADA Standards
• False Claims Act lawsuits aren't the only employee-initiated legal actions you have to... Read more
Industry Note:
Tap These New MAC Tools For Hospice Billing Help
Looking for help with your hospice billing? HHH MAC NHIC has posted three new hospice-rel... Read more
Industry Note:
Study: Falls May Indicate Early Alzheimer's
If you have patients who seem mysteriously prone to falls, they may be in the early stage... Read more
Industry Note:
This Month MACs Offer 2nd Chance For 5010 Testing
Providers that missed the last 5010 testing day should put these dates down on their cale... Read more
Prospective Payment System:
2012 Cuts To Hit Therapy-Heavy HHAs The Hardest
Proposed cuts are even bigger than CMS says, industry sources maintain. How next year's p... Read more
Diagnosis Coding:
Diagnosis Codes Slated For Elimination No Longer Predict Costs, CMS Says
Use of 401.9 more than doubled in last five years. The Centers for Medicare & Medicai... Read more
Therapy:
20-Visit Threshold Sees Biggest Payment Decrease Under Case Mix Changes
The feds are aiming changes at scammers who pad their therapy visits. The only question s... Read more
Fraud & Abuse:
Outliers On Track For Decrease
Don't overlook the PPS rule's smaller provisions. The reimbursement cuts due to case mix ... Read more
Industry Note:
Tap Educational Resources From New HHH MAC
Get advice on billing issues ranging from logging onto DDE to avoiding duplicate file rej... Read more
Industry Note:
Majority Of Power Wheelchair Claims Don't Meet Medic-are Requirements
Wheelchair suppliers may face even more red tape in furnishing items to Medicare benefici... Read more
Industry Note:
Don't Date Stamp Hospice Terminal Illness Certs Unless You Want Denials
Put away those date stamps for your hospice patients' terminal illness certification, or ... Read more
Industry Note:
Examine This Case Study For Cost-Cutting Tips
If you're looking to cut your spending in these trying financial times, you may want to t... Read more
Industry Note:
Two California HHA Owners Found Guilty Of Fraud
A federal jury has found one home health agency owner in California guilty of Medicare fr... Read more
Industry Note:
Regional Chain Buys Florida Home Health Agency
Regional chain CareSouth Health System Inc. is purchasing its third home health agency in... Read more
Industry Note:
Multiple Regions See Hospice Inpatient Units Opening Their Doors
Hospice inpatient units continue to proliferate. Pikes Peak Hospice & Palliative Care... Read more
Prospective Payment System:
HHA Payment Rates Slashed 3% For 2012
Prospective payment system proposed rule holds bad news for home health agencies. Get read... Read more
Regulations:
Face-To-Face Proposal Could Ease HHAs'Workload
Under new rule, some physicians could report F2F encounters like NPPs. The face-to-face p... Read more
Referrals:
Improve Your Physician Relationships With SBAR Tool
Tip: Establish a rapport with office staff to hasten communication improvement. Home care... Read more
Policies & Procedures:
Use These Doc Communication Boosters
Put an end to phone tag. Already using an SBAR tool to plan your communication with physi... Read more
Fraud & Abuse:
Chicago-Area HHA Owner Indicted On Fraud
'Lavish lifestyle' bought with Medicare fraud money, prosecutors allege. The feds' crackd... Read more
Industry Note:
Know Your FISS Status Codes To Speed Claims Payment
Don't waste time trying to change claims that are in an 'S' location. Wondering what's go... Read more
Industry Note:
Get RAP Dates Right
Don't forget to complete the  "THROUGH" date "THROUGH" date on your Request for Antic... Read more
Industry Note:
Note These Changes To Hospice Cost Report Form
The hospice cost report form and instructions have some changes related to inpatient gener... Read more
Industry Note:
DME Bidding Doesn't Harm Benes, CMS Maintains
Durable medical equipment suppliers may see more competitive bidding in their future. Base... Read more
Industry Note:
Why Copays Are Bad
Lawmaker negotiations over the U.S. deficit and government spending cuts continue, with Me... Read more
Industry Note:
Medicaid HHA Fraudsters Sentenced To Years In Jail
The crackdown on Medicaid fraud in home care continues. In Winston-Salem, N.C., two Medica... Read more
Industry Note:
2 IL Health Systems Merge
A new merger in Illinois will create the largest Catholic health system in the state, whic... Read more
Industry Note:
NH Agency Expands
The Homemakers Health Services in Rochester, N.H. is expanding its service area to include... Read more
Industry Note:
Post-Acute Chain Buys New Mexico Agency
A subsidiary of holding company Skilled Healthcare Group Inc. plans to buy HHA Altura Home... Read more
HIPAA:
Your Employees' Facebook Posts Can Come Back To Haunt Them -- And You
Don't risk patients' privacy just to blow off steam. The last thing your home care organi... Read more
Regulations:
F2F Denials Have Begun
HHAs continue to struggle with meeting face-toface obligations. Add the cost of denied cl... Read more
Compliance:
Follow These 5 Steps To Protect Against F2F Claims Denials
Are you doing everything you can to boost your face-to-face compliance? It's no longer ju... Read more
HIPAA:
Have Patient Data? You Can Still Travel Safely
Just make sure you maintain your HIPAA compliance on the road. Protecting your clients' p... Read more
Patient Privacy:
Focus On Your Laptop's Physical Security
You can minimize the risk of people inadvertently seeing protected health information on y... Read more
Budget:
Watch Washington For Copay Threat
Study spells out why copays are bad for benes. Grappling with current regulatory and reim... Read more
Industry Note:
Pre-Pay Claims Review Heats Up
Predictive modeling could target your claims. Get ready for more scrutiny of your claims ... Read more
Industry Note:
New Therapy Reassessment Q&As Hold Bad News
CMS may not have been able to answer many questions at the latest Open Door Forum, but it... Read more
Industry Note:
Controversy Dogs New Medicare Board
The tide of provider sentiment may be against the new "Super-MedPAC," but the Obama admin... Read more
Industry Note:
OIG Frowns On Supplier-IDTF Relationship
Be careful if you are a CPAP supplier with ties to Independent Diagnostic Testing Facilit... Read more
Industry Note:
Duplicative Medical Records Submission Eliminated For RAC Appeals
Your RAC appeals process should get a little less burdensome if Palmetto GBA is your Medi... Read more
Industry Note:
Watch Out For Closed Medicare Bank Accounts
If you get a Medicare check returned with an "account closed" message, don't panic. CMS ... Read more
Industry Note:
Kentucky To Run Fingerprint Criminal Background Checks Thanks To ACA Program
Home care job applicants in Kentucky will start undergoing more stringent criminal backgr... Read more
Industry Note:
Wall Street Analyst Forecasts Tough 2012 For Home Care Companies
If you think next year is going to be a tough one for home care companies, you're not alo... Read more
Industry Note:
Minnesota Provider Faces Medicaid Fraud Charges
The federal government's stepped-up enforcement continues to spread to states. In Minneso... Read more
Hospice:
Scrutinize Charges Unrelated To Hospice Terminal Diagnosis -- Before Reviewers Do
Use 3 tips to survive the feds' new focus. The cost of caring for your hospice patients m... Read more
Medical Review:
RACs May Bite On Hospice Unrelated Charges
Data-driven review lends itself to terminal diagnosis issue. Recovery Audit Contractors h... Read more
Fraud & Abuse:
New DME Fraud Pilot May Be Model For HHAs
DME suppliers to voluntarily take part in card swipe fraud-fighting initiative. One Medic... Read more
Human Resources:
Boost Staff Morale With This Praise Tool
Also use one simple tip to turn around chronic complainers. Looking for ways to keep staf... Read more
Industry Note:
Regulatory Review Unlikely To Lighten Your Load On F2F
Health care reform provisions won't undergo scrutiny. Don't expect a sudden reprieve to c... Read more
Tool:
Staff Can Use This Form to Share How They Are Helping Patients
Form puts a new spin on 'incident report.'  ... Read more
Industry Note:
Cahaba-To-CGS Transition Comes With Cash Flow Hang-Ups
Home health agencies and hospices getting used to their new Medicare contractor are also ... Read more
Industry Note:
Watch For New PECOS Edit Deadline
Home care providers now have the delay to their PECOS edits in writing. Previously, the C... Read more
Industry Note:
Turn To This Resource For Emergency Waiver Info
Waivers of some regulatory requirements went into effect in certain parts of Missouri due... Read more
Industry Note:
Do Your HEAT Compliance Training In Small Pieces
Don't have the time to sit through the nearly four-hour HEAT training session the HHS Off... Read more
Industry Note:
Patients Writing Vaccination Reminders Ups Compliance
If you run flu vaccination drives, some new information from the National Institutes of H... Read more
Industry Note:
Aide Retention Tough, New CDC Report Says
The need for home care aides is rising, but drawbacks to the job may make recruiting incr... Read more
Industry Note:
Step Up To The Plate For PS&R Reports
If you fail to download your PS&R report from the new system, it will be you that's o... Read more
Industry Note:
Controversy Erupts Over Hoosier State Home Care
Many home care providers are seeing their state budgets for the Medicaid benefit cut. Cas... Read more
Industry Note:
Keep Your Mind Open To Non-Traditional Biz Lines
If you're looking for ways to keep your home care organization healthy, you shouldn't ove... Read more
Regulations:
Therapy 30-Day Worries Hound Home Health Agencies
Face-to face, outliers, and quality data submission also discussed in latest Open Door Fo... Read more
OASIS:
Prepare For OASIS-C Quality Measures To Go Public
Has your OASIS data under the new assessment form been accurate? Wondering what exactly i... Read more
Billing:
Are You And Your Vendor Ready To Use the 5010 Form?
The June 15 test date is here. The Centers for Medicare & Medicaid Services is hostin... Read more
HIPAA:
Employees Peeking at Patients' PHI? Soon, Patients May Know
HHS wants you to give patients access to a list of providers who accessed their records. ... Read more
Information Technology:
Maintain Enough Storage For Records Under 5010
Question: Our vendor oversees our medical records storage systems -- should they be ... Read more
Industry Notes:
Fraud-Fighting Focus Racks Up Billions In Recoveries For OIG
Latest OIG report to Congress highlights HHA therapy fraud case. Citing a "period of inte... Read more
Industry Note:
Make Sure Your Paperwork Is In Order For Smooth Cahaba-CIGNA Switch
The transition from Cahaba GBA to CIGNA Government Services is at hand, and you should ha... Read more
Industry Note:
Manual Now Reflects Transfer Clarifications, G Codes
The Centers for Medicare & Medicaid Services has released a lengthy update to Medicar... Read more
Industry Note:
Public Reports On Your Quality, Cost On Deck
You could soon be under even more public scrutiny than Home Health Compare brings you. CM... Read more
Industry Note:
Beware F2F Checkboxes
You should keep checkboxes off the face-to-face documentation forms you give physicians t... Read more
Industry Note:
Watch For CMS Transmittal On Hospice F2F Billing
Watch for a forthcoming CMS transmittal on how to handle hospice billing when the face-to... Read more
Industry Note:
Access HEAT Training
You can now tune into the same HEAT compliance training that the HHS Office of Inspector ... Read more
Industry Note:
Deadline For PECOS Edits Still Up In The Air
You can put PECOS edits a little further down on your crowded priority list. CMS "has not... Read more
Industry Note:
Put NPI On Your Check
If you need to make a repayment to Medicare and Palmetto GBA is your MAC, be sure to incl... Read more
Industry Note:
National Chain Pays $12.5M To Settle Fraud Charges
Cost-based reimbursement may be long in the past, but a multi-million-dollar settlement m... Read more
Compliance:
Steer Clear Of F2F Violations With Medical Directors
Face-to-face rules may be different for another physician's patients. Do you know when it... Read more
Hospice:
Put These Hospice Hot Spots On Your Radar
A hospice copayment proposal could rear its ugly head in 2011. Don't be surprised to see ... Read more
Know Your Facts:
Rising Hospice Stats Inform Policy Decisions
Average LOS soars, but median LOS remains steady. The Medicare Payment Advisory Commissio... Read more
Diagnosis Coding:
Transition To ICD-10 On Time Or Face Millions In Fines
Plus: CMS officials consider how to handle claims that span the pre- and post-ICD-10 impl... Read more
Industry Note:
Miami Diabetes Fraudsters Face Jail Time
Fraud Strike Force's crackdowns are yielding fraud convictions. One of the home care nurs... Read more
Industry Note:
LTC Insurance Program To Take Step Closer To Imple-mentation
Expect some changes to the CLASS Act program that may help it to actually launch -- a... Read more
Industry Note:
Wrong NPI Type, Specialty Trigger Edits
Don't be too quick to blame PECOS for all the informational messages you receive about cla... Read more
Industry Note:
ICD-10 Coding Crosswalks May Make Your Life Easier
Don't overlook a valuable resource in making your transition to the ICD-10 diagnosis codin... Read more
Industry Note:
Home Care Overlooked Again In MedPAC Appointments
MedPAC has two new members starting next session, and they still don’... Read more
Industry Note:
RHHI-To-HHH MAC Transition Set For June 13
If you're currently served by Cahaba GBA and you didn't turn in your new EFT form to CIGNA... Read more
Industry Note:
Rental Car Donor Eases Workers' Gas Woes
Trying to think of a way to offer some relief to your visiting staff in the face of high g... Read more
Industry Note:
Regional Chain Expands California Locations
Walnut Creek, Calif.-based Professional Healthcare at Home has opened an additional Medica... Read more
Industry Note:
Texas Hospice Opens Inpatient Facility
Solari Hospice Care in Houston has opened a new 8,000-square-foot, 12-bed inpatient hospic... Read more
Reader Question:
Know Your F2F Signature Requirements To Keep Your Rightful Reimbursement
Don't let a technical oversight shoot down your Medicare pay -- or your compliance r... Read more
Kickbacks:
Reconsider Your Online Referral Subscription
OIG gives thumbs down to referral software. Home care providers feeling cornered by hospi... Read more
Compliance:
Use These 4 Tips To Sidestep F2F, Therapy Compliance Pitfalls
Cast a compliance eye on the new regulatory requirements that hit April 1. Don't get so c... Read more
Fraud & Abuse:
OIG Plans To Crack Down On Documentation Requirements
Mandatory compliance plans are on deck, OIG says in HEAT training session. Home care prov... Read more
Compliance Plans:
Your Compliance Plan Should Include These 7 Elements
"While the specifics are still being ironed out through the regulatory process, we do know... Read more
Disaster Planning:
Are Your Emergency Preparedness Plans Ready?
Recent natural disasters serve as grim reminders. Among the people affected by recent nat... Read more
Industry Note:
Hospices Get Early Look At Hospice Cap Amount
Use the info to make cap appeals decisions. Hospices have a lot of decisions to make this... Read more
Industry Note:
New Agencies Can't Ignore OASIS
Recently enrolled HHAs should start submitting OASIS data by June 30 to avoid a 2 percent... Read more
Industry Note:
Edits Checking Type Of Admission Codes Reactivated
Type of admission codes are giving hospices more headaches, but the issues soon should be... Read more
Industry Note:
Medicaid F2F Requirement Looms On Your Horizon
If you haven't seen a physician face-toface requirement for home health and/or hospice in... Read more
Industry Note:
You'll See Vaccine Roster Billing Fix In July
A solution for vaccine roster billing will take effect in July. Now: "Reason code 31596 c... Read more
Industry Note:
Get Ideas For Vision-Related Falls Reduction Here
Looking for ways to help reduce falls in your visually impaired patient population? You m... Read more
Industry Note:
Don't Forget "OTH PHYS" Field On Claims
Just because you can leave the "OTH PHYS" field on hospice notices of election blank does... Read more
Industry Note:
Two Regional Chains Merge Into One
Two regional chains are merging to create a larger presence in the Southeastern U.S. Nash... Read more
Prospective Payment System:
Expect Even Lower HHA Rates From PPS Rebasing
CMS plans to reduce payments due to bundling of physician-provided therapy. The feds now ... Read more
Diagnosis Coding:
Use These M1024 Tips To Get Your Rightful Reimbursement
Does your software need a tune-up? If you miss getting a diagnosis code into M1024, it co... Read more
Fraud & Abuse:
Authorities Crack Down On Home Care Fraudsters
More fraud-fighting activity takes place in Minnesota, Texas. Ironically, a clean-up of t... Read more
Human Resources:
Help Your Employees Buy In To Change
Tip: Explaining why the change is necessary is essential for managers. The home care indu... Read more
Industry Notes:
HIPAA Vulnerabilities May Haunt Your Organization
Tip: Get your laptops encrypted. Are these "high-impact" vulnerabilities to protected hea... Read more
Industry Notes:
Medicare Officials Want ACOs To Tackle Dual Eligible Problems
Medicare officials would like to see Accountable Care Organizations help alleviate yourpr... Read more
Industry Notes:
Medicare Trust Fund Projected To Remain Solvent Until 2024, Trustees Say
Medicare's Hospital Insurance (HI) Trust Fund is projected to remain solvent until 2024, ... Read more
Industry Notes:
Check Out HEAT Compliance Training Materials
Even if you didn't get a chance to attend the OIG's HEAT compliance provider training, yo... Read more
Industry Notes:
Find The Missing Wage Index Chart For Hospice Here
Wondering where the rural area wage index chart was in the hospice proposed payment rule?... Read more
Industry Notes:
New York Times Profiles Home Care Insurance Woes
The industry's effort to avoid potentially disastrous employee insurance costs under the ... Read more
Industry Notes:
Therapy Claims System Glitch Now Resolved
You can expect to get your money back from one Medicare claims system glitch by June 30. ... Read more
Industry Notes:
Health System Merger Leads To HHA Closure
One Troy, N.Y. HHA is closing its doors as a result of a health system merger. Seton Heal... Read more
Industry Notes:
Post-Acute Parent Co. Buys Utah Home Care Provider
A subsidiary of The Ensign Group Inc. has acquired Symbii Home Health and Hospice based i... Read more
Education:
Get Training On OASIS C, Hospice Doc Billing, Therapy, And More
Check out upcoming Eli audioconferences on OASIS C and wounds, OASIS tips for therapists,... Read more
Therapy:
Adopt A 'Tracking'Mindset For 30-Day Therapy Reassessments
Therapists' frustration mounts as new requirements sink in. Making sure you hit your dead... Read more
Regulations:
Avoid These 6 Pitfalls For New Therapy Reassessments
Tip: Keep your reeval documentation simple. Mixing up the visit counting requirements isn... Read more
Reimbursement:
Outlier Fix On The Way, But Is It Enough?
CMS to fix glitches in HHA outlier payments. Have you been under the 10 percent outlier c... Read more
OASIS:
Know The M1024 Ropes Or Risk Your PPS Payment
Here's when to fill in M1024 -- and when not to. Since the home health prospective p... Read more
Finance:
Home Health Company Profits Fall In 2011
Revenues continue to rise, however. If you've seen falling income so far this year, you'r... Read more
Industry Notes:
Bill Allowing PAs As Hospice Attendings Would Up Access
Hospices may see more Medicare beneficiaries on their rolls if proposed legislation to imp... Read more
Industry Notes:
Will IPAB Get Repealed?
The so-called "Super-MedPAC" established in the health care reform law last year is comin... Read more
Industry Notes:
Tap These 5010 Resources
The Jan. 1 compliance date for the new HIPAA 5010 standards is fast approaching. Take adv... Read more
Industry Notes:
Doc Fix Threatens Home Care Reimbursement
Watch out for possible rate cuts coming down the legislative pike this session. Physician... Read more
Industry Notes:
RACs Rack Up Millions In Recoupments
Recovery Audit Contractors may not have cracked down on home health agency and hospice pr... Read more
Industry Notes:
Senior Patrol Ranks Swell, But Fraud Findings Shrink
You may have more seniors looking over your shoulder, but they are finding less fraud to ... Read more
Industry Notes:
Solve Overlapping Claims Problems With This Resource
Not sure how to resolve problems due to claims overlapping with another provider? Check o... Read more
Industry Notes:
Catch Sold-Out OIG Training Via Webcast For Free
Did you miss the OIG's recent compliance training sessions in person? Don't worry, you ca... Read more
Industry Notes:
Don't Let 'Dim Days' Take You By Surprise
If Palmetto GBA is your HHH MAC, don't be surprised when no payments or remittance advice... Read more
Hospice:
Hospices To See 2.3% Pay Bump Starting This Fall
But BNAF wage index reduction takes $80 million out of hospices' pockets. Hospices should... Read more
Compliance:
2 Steps Help Ward Off Payment Suspensions For 'Credible' Fraud Allegations
Home in on these 3 sources of fraud complaints. Beware a new Affordable Care Act provisio... Read more
Regulations:
Will Hospice Face-To-Face Change Ease Your Burden?
CMS proposes loosening up who can make the F2F visit for hospice patients. Your hospice f... Read more
Audits:
Don't Cross The Line When Teaching Staff How To Respond To Auditors, Surveyors
Beware ever saying this. Solid bet: "With all the different entities out there doing audi... Read more
Industry Notes:
F2F Requirement Under Fire In Mainstream Press
New senate letter circulates on the face-to-face requirement. The public is taking notice... Read more
Industry Notes:
OIG Scrutinizes Consolidated Billing
Don't be surprised if you start getting old bills from durable medical equipment supplier... Read more
Industry Notes:
Follow This Wound Photo Guidance
The Wound, Ostomy and Continence Nurses Society has published a position paper that inclu... Read more
Industry Notes:
Take These Steps When A Patient Won't Sign An HHABN
What do you do when a patient won't sign a home health advance beneficiary notice? This c... Read more
Industry Notes:
Beware Adjustments To Outlier Claims
If you need to submit an adjustment for a claim that includes an outlier payment, don't c... Read more
Industry Notes:
Catch Up On Your Cahaba-To-CIGNA Duties
The transition from Cahaba GBA to HHH MAC CIGNA is ramping up. HHAs and hospices should a... Read more
Industry Notes:
Compare Yourself To These NCLOS Benchmarks
If your non-cancer length of stay rates for hospice patients vary widely from the norm, y... Read more
Industry Notes:
Amedisys Sees Big Earnings Drop This Quarter
Amedisys Inc. saw its earnings drop in the latest quarter. The Baton Rouge, La.-based nat... Read more
Industry Notes:
Salt Lake City Home Care Providers Merge
Two Salt Lake City home care providers have become one. Community Nursing Services, a not... Read more
Industry Notes:
Get To Know New Doc Field In FISS Screen
Get to know a new field in your FISS screen. As of April, "FISS Claim Page 03 was revised... Read more
Reader Question:
What Counts As 'Close To' For Therapy Reevals?
Don't dupe yourself into providing unnecessary non-billable therapy visits. Reader Questi... Read more
Therapy:
Use These New Manual Rules To Count Your Therapy Reassessments Correctly
CMS addresses therapy questions in latest Open Door Forum. Want to take a gamble on what ... Read more
Regulations:
HHAs Get F2F Answers In Latest Medicare Forum
Clarifications to face-to-face questions contain good and bad news. Enforcement of the ph... Read more
OASIS:
Jettison M1012 From Your OASIS Worry List
Plus: Watch for OASIS-C-based reports and outcomes to go public this summer. You now have... Read more
Contractors:
Pay Attention To This Deadline Or Risk Your Cash Flow
Cahaba-to-CIGNA contractor transition has nationwide impact. AMay 6 deadline could stop y... Read more
Diagnosis Coding:
This Tip Gets You Closer to ICD-10 Compliance
Hint: Dig deep for specifics like unilateral, bilateral, and post-traumatic. You're going... Read more
Industry Notes:
Use This Workaround To Sidestep Hospice NOE Glitch
The good news is one nagging hospice claims system error is resolved. Top on the list of ... Read more
Industry Notes:
Outlier Claims Snafu Trips Up HHA Payments
HHAs are having trouble with some claims payment issues as well. For example: Agencies ar... Read more
Industry Notes:
New Medicaid Projects Target Dual Eligibles, Olmstead Compliance
A few new Medicaid initiatives could benefit home care providers. A new program required ... Read more
Industry Notes:
Fuel Prices Stress Home Care Providers
Gas prices are up nearly a dollar per gallon compared to a year ago, and so are many home... Read more
Industry Notes:
Say Goodbye To Extra 1099 Reporting For Sure
On April 14, President Obama signed into law legislation removing the extra 1099 tax &nbs... Read more
Industry Notes:
You Can Soon Take Your Pick On Hospice Cap Calculation
You may soon have a choice about how your hospice cap is calculated. So says a CMS Ruling... Read more
Industry Notes:
Consider These Wrinkles When Joining ACOs
Get ready to rev up your marketing machine as your local hospitals and physician groups f... Read more
Industry Notes:
New Alzheimers Diagnostic Guidelines Out After 27 Years
You may see some changes in how your patients with cognitive impairment are diagnosed, ba... Read more
Industry Notes:
Hospital Pay Proposal Could Boost Home Care Alliances
Hospitals' latest proposed payment rule from CMS should give them extra incentive to impr... Read more
Industry Notes:
National Chain Makes Big Hospice Buy
National chain Amedisys Inc. has agreed to pay about $125 million for Boston-based Beacon... Read more
Regulations:
Home Care Providers Forge Ahead With F2F Implementation
Newly introduced legislation addresses face-toface encounter problems. Home care provider... Read more
Hospice:
Proving Services Unrelated To Terminal Dx May Get Harder
Many hospice complaint surveys are underway, CMS says. It may be wise to beef up your doc... Read more
OASIS:
3 Tips To Keep OASIS, Therapy Documentation Consistent
Don't hem yourself into a 24-hour turn-around. Cleaning up inconsistencies between OASIS ... Read more
Education:
Get Training On OASIS C, HIPAA Changes And More
Check out upcoming Eli audioconferences on documenting homebound status, wage and hour l... Read more
Reimbursement:
Timely Filing Problem Solved With System Bypass
HHAs with incorrectly rejected claims must turn to contractor. Medicare's new 12-month ti... Read more
Industry Notes:
Feds Sink $1 Billion Into Community Transitions
Home care plays a key part in helping patients transition out of the hospital safely. Med... Read more
Industry Notes:
Learn This New Billing Requirement Or Risk Returned Claims
Don't forget to include Type of Admission codes on your claims. "The Priority (Type) of ... Read more
Industry Notes:
OIG Advises Return To Operation Restore Trust
The government's fight against health care fraud has been heating up, and you can expect ... Read more
Industry Notes:
The Fix Is In For Vaccine Billing Problem
The Medicare claims system will now let you bill for the administration of a vaccine with... Read more
Industry Notes:
Don't Neglect Technicalities In Appeals Requests
Don't let operational glitches trip up your appeals request. For example, in addition to ... Read more
Industry Notes:
Verification For Hospice Glitch Fix Still Pending
Don't rush to resubmit your hospice claims returned with error code 31503. The claims sys... Read more
Industry Notes:
Consider These Website Changes To Capture Business
If your website doesn't currently emphasize your experience and staff credentials, you &n... Read more
Industry Notes:
Hospital Consolidates Two HHA
Industry consolidation continues, even at the micro level. Southcoast Health System in Ne... Read more
Industry Notes:
One State's Counties Mull Selling Home Care Agencies
A few more New York counties are considering getting out of the home care business. The W... Read more
Regulations:
It's Official: You Must Comply With F2F
Industry campaign to delay face-to-face requirement continues. You should have no doubts ... Read more
Therapy:
Use This CMS Tip To Make Your Therapy Reassessment Window
Send therapists out early in these cases. The face-to-face encounter requirement isn't th... Read more
Reimbursement:
HHA Cuts Loom On The Horizon
Access study may pave way for more reimbursement changes. Reimbursement reductions that o... Read more
Compliance:
Are You Vulnerable To This HIPAA Violation?
If your staff carries paper PHI offsite, implement these proactive strategies. HIPAA enfo... Read more
Strategy:
Put Accountable Care Organizations On Your Radar
These health reform law-required coalitions could change how you furnish care forever. Ho... Read more
Industry Notes:
House Leader's Budget Proposal Threatens Home Care
Voucher system could mirror Medicare Advantage. A new 2012 federal budget proposal could ... Read more
Industry Notes:
CMS Announces Delay To Round 2 Of DME Competitive Bidding
Competitive bidding for durable medical equipment may take a bit longer to come to your ar... Read more
Industry Notes:
Tenn. Provider Socked With Wage & Hour Back Pay
You'd better watch how you're paying your home health aides, or you could end up owing ten... Read more
Industry Notes:
Include Type Of Admission Codes on RAPs, RHHI Says
A new Medicare claims system update means new payment problems to work through. Unbeknowns... Read more
Industry Notes:
CDC Issues New Guidelines For Preventing Catheter-Related Bloodstream Infections
Get up to speed on new guidelines to eliminate catheter-related bloodstream infections (CR... Read more
Industry Notes:
Tune Into CIGNA Call
Wondering how your transition to CIGNA will go if you're a home health agency or hospice c... Read more
Industry Notes:
Congress Passes Repeal Of 1099 Reporting Change
Your 1099 worries soon should be over. Congress has passed a repeal of the tax reporting r... Read more
Industry Notes:
Home Health M&A Busy Across The Country
There's more activity in the home care mergers and acquisitions market. CareSouth Homecare... Read more
Regulations:
HHA Industry On Brink Of F2F Crisis With No Delay
One agency tells CMS 98% of F2F paperwork isn't adequate. Physicians' inability or unwill... Read more
Hospice:
No Hospice F2F? You Must Discharge From Medicare
CMS sheds light on face-to-face gray areas in new questions and answers. If you miss gett... Read more
Medical Review:
Watch Out For Hot Button Medical Review Topics
Are you waving these red flags in front of reviewers' faces? To stay off medical reviewer... Read more
Survey & Certification:
Make Criminal Background Checks A Priority Before Surveyors Do
CMS's background check program for HHAs, hospices is running in 10 states so far. How tig... Read more
Compliance:
Take These 3 Steps To Head Off Background Check Problems
Are you checking the FBI database? How can your home care organization head off survey, c... Read more
Industry Notes:
A Single Finding Will Move You To Partial Extended Survey
CMS revises survey protocols. New survey rules for home health agencies will go into effe... Read more
Industry Notes:
Palmetto GBA Parent Buys CIGNA Government Services
Home health agencies and hospices transferring from Cahaba GBA to CIGNA Government Servic... Read more
Industry Notes:
Title Supervisory Visits In The Schedule
Is keeping in compliance with rules for aide supervisory visits proving difficult? These ... Read more
Industry Notes:
Copay Returns To The Budget Table
President Obama's proposed budget for 2012 may not include a home health copayment, but t... Read more
Industry Notes:
Bypass New Enrollment Fee If You Know The Ropes
If you're wondering how to pay your Medicare enrollment or revalidation fee under new app... Read more
Industry Notes:
Watch Out For Claims Edits On Site Of Service
Medicare has implemented edits that will return your hospice claims submitted with an ina... Read more
Industry Notes:
Claims Glitch Clears Up
Claims submitted to Palmetto GBA that were stuck in status location SB9099 should be proc... Read more
Industry Notes:
Chain Makes Ohio Buy
Louisville, Ky.-based Almost Family Inc. is buying the assets of the Medicare-certified h... Read more
Industry Notes:
Physician Gets Jail Time For Home Care Fraud
The physician involved in a Miami-area home care fraud ring has been sentenced to two yea... Read more
Industry Notes:
Note This ICD-10 Change
When ICD-9 becomes ICD-10 in 2013, you'll need to know how to categorize your care by enc... Read more
Documentation:
Use Orders, Discharge Summary To Satisfy F2F
Don’t duplicate face-to-face efforts unnecessarily. Some eleventh-hour guidance ... Read more
Regulation:
New F2F Clarification May Help With Your Doc Troubles
Physician staff can prepare the face-to-face documentation, CMS says in new Q&A. With... Read more
Compliance:
Are You Protecting Yourself From Compliance Allegations?
The answers to these 5 questions can help you ward off compliance risks. Most home care p... Read more
OASIS:
Say 'Yes'To New M1500 Clarifications
New guidance could result in taking a hit to your process measure scores. A new clarifica... Read more
Industry Notes:
OIG Wants More Scrutiny Of HHAs, Hospices
Outlier payments, nursing home-hospice interactions could raise red flags. If you receive... Read more
Industry Notes:
Check Out New Hospice Manual, Including F2F Language
Hospices now have an updated Medicare Benefit Policy Manual to reference. Most notably, t... Read more
Industry Notes:
Use New HHABN Form Or Fail To Meet F2F Requirement
Don't forget to use the new home health advance beneficiary notice starting April 1. "Man... Read more
Industry Notes:
2 % Of Fraud Tips Unresolved
CMS's response to fraud tips soon may improve. About 12 percent of complaints received th... Read more
Industry Notes:
Smooth Cahaba-CIGNA Switch With 'Early Boarding'
If you're an HHA or hospice currently served by Cahaba GBA, watch the mail for a packet f... Read more
Industry Notes:
Fix For DDE Page Glitch Slated For June
Starting June 6, some annoying extra keystrokes will be gone from DDE. On that date, Medi... Read more
Industry Notes:
Use This Form For Clerical Reopenings
If you want a clerical error reopening of a claim from HHH MAC NHIC, you should use the f... Read more
Industry Notes:
Don't Cancel Or Adjust These Claims, RHHI Warns
Hold up, you don't want to go canceling or adjusting your claims that are in status/locat... Read more
Industry Notes:
You Should Be Complying With HIPAA 5010 Already
Are you ready for HIPAA 5010 requirements? Providers already should be in Level I complia... Read more
Industry Notes:
HHA Files Suit Against Employees Stealing Patients
You'd better keep a close eye on your employees, or you may find yourself in the shoes of... Read more
Reader Question:
Know The Rules For Counting Your Therapy Visits For Reassessment
CMS issues clarification in new therapy fact sheet. Without Medicare manual instructions ... Read more
Regulations:
HHAs Hit Physician Wall Over F2F Encounters
Docs threaten to cut off home care referrals in face of burdensome new requirements. T... Read more
Strategy:
Try These 6 Tips To Tackle Your F2F Challenges
Educate, educate, educate. The face-to-face encounter rule isn't going away, and that mea... Read more
Reimbursement:
MedPAC Urges Congress To Impose Home Health Copay
Advisory body predicts 14.5 percent profit margin for HHAs in 2011. Yet another barrier t... Read more
Policy:
MedPAC Recommendations To Congress
In addition to imposing a copayment for home health agency episodes and keeping HHA payme... Read more
Compliance:
RAC Bounty Hunters Take Aim At Medicaid Claims
Recent delays give you more time to plan for these audits. If you've been ignoring RACs b... Read more
Industry Notes:
Intermediary Edit Denies 75% Of Long-Stay Hospice Claims
Make sure your documentation will hold up. Hospices that aren't documenting their long-st... Read more
Industry Notes:
Congress Focuses On Preventing Medicare Fraud
Don't be surprised to see fraud and abuse enforcement ramp up for home care pro-viders. T... Read more
Industry Notes:
Expect Fix For HospiceClaims Glitch In April
A fix is finally scheduled for a hospice claims glitch discovered in January. The problem... Read more
Industry Notes:
Bill Introduced To Repeal DME Competitive Bidding
DME suppliers are pinning their hopes for a competitive bidding repeal on new legislation... Read more
Industry Notes:
Medicare System Shorts HHAs 2 Months For Timely Filing
Watch out: Under timely filing rules you may have only 10 months instead of 12 to submit ... Read more
Industry Notes:
Get Your NPI Questions Answered With New Booklet
Trying to figure out whether it's OK for your locations to have the same NPI? You might w... Read more
Industry Notes:
Don't Miss These Crucial CIGNA Takeover Deadlines
Don't miss these crucial deadlines in the Cahaba-to-CIGNA transition, or your Medicare pa... Read more
Industry Notes:
Home Care Popularity Empties Nursing Homes
The effort to keep seniors in their homes may face some opposition from nursing homes. C... Read more
Reimbursement:
Retool Your ABN Process For F2F Encounter Discharges
CMS backtracks on face-to-face ABNs. The feds have changed their tune on a requirement fo... Read more
Regulations:
Tackle Therapy Changes On Your Own
CAHPS, home care access, OASIS also addressed in latest Open Door Forum. In just a few sh... Read more
Prospective Payment System:
Learn PPS Ropes To Get The Supply Points You Deserve
Make sure you're getting your rightful NRS reimbursement. Nonroutine medical supplies can... Read more
Diagnosis Coding:
Pin Down These NRS Diagnoses For Fair Reimbursement
Mind your sequencing to get all the case mix points you're entitled to. Under the prospec... Read more
Industry Notes:
New Enrollment, Revalidation Fees Hit Home Care Providers
Also: Your chances of screening scrutiny increase this month. Starting March 25, you'll h... Read more
Industry Notes:
5-Visit Episodes Attract Medical Review Attention
If you're submitting claims for five-visit episodes with a single nurse or social worker ... Read more
Industry Notes:
Deadline Looms While Suppliers Wait On Bidding Form C
Bid contract suppliers are anxiously awaiting bidding Form C, but it still isn't out at p... Read more
Industry Notes:
Contractor Discontinues Medicare Denial Letters
If you need a Medicare denial to bill another payer for your services and Palmetto GBA is... Read more
Industry Notes:
Log On To IACS System Bi-Monthly Or Lose Access
Put one more thing on your to-do list: If you don't log in to the IACS system every few m... Read more
Industry Notes:
CMS Improved PECOS System, But Will It Help?
Are you still having trouble getting your referring physicians to enroll in PECOS? You ar... Read more
Industry Notes:
Federal Court Decision Invalidates Hospice Caps
A recent federal court decision may bring hospices one step closer to the end of theMedic... Read more
Industry Notes:
Tap This Medication Tool, Training From The AMA
  Looking for a tool to help your patients manage their medications safely? A new med... Read more
Industry Notes:
HHA Chain Reports Mixed Earnings
Earnings were up but profits were down for HHA chain LHC Group Inc.'s latest quarter. The... Read more
Reader Question:
Get Quarterly Reconciliation Facts Straight For Outliers
You'll get your outlier payments eventually, if you stay under the 10 percent cap. Questi... Read more
Pay For Performance:
Will P4P Program Take Money Out Of Your Pocket?
CMS readies congressional report on value-based purchasing this fall. Getting docked for ... Read more
Regulations:
Value-Based Purchasing Plan May Resemble P4P Demo
Expect CMS to take action on a VBP plan soon, expert predicts. For a clue as to what poli... Read more
HIPAA:
Don't Let HIPAA Noncompliance Topple You
Beware 'willful neglect' penalties up to $50,000 per violation now in effect. If you thin... Read more
Enforcement:
HHS Slaps $1 Million HIPAA Fine On Provider For Lost Data
Warning: HIPAA enforcement is ramping up. The feds don't seem afraid to use their HIPAA f... Read more
Industry Notes:
Industry Earnings Mixed After Rate Cuts, Investigations
Amedisys sees earnings dip. The 5 percent rate cut that took effect Jan. 1 managed to tak... Read more
Industry Notes:
Therapy Best Practices Report Offers Guidelines
HHAs looking to avoid compliance problems sparked by the congressional therapy investigat... Read more
Industry Notes:
Fraud Strike Force Expands To 2 New Cities
Fraudulent home care providers figured prominently in the feds' latest massive fraud bust... Read more
Industry Notes:
New Interpretive Guidance Makes Clear, No Signature Stamps
Take a look at the new guidance CMS is issuing to your surveyors. CMS issued an advance c... Read more
Industry Notes:
Don't Jump The Gun On Cahaba-CIGNA Switchover
Don't jump the gun on the switchover from Cahaba GBA to CIGNA as your Medicare contractor... Read more
Industry Notes:
Haven't Responded To CERT? Expect A Call From CMS
You'll be bringing yourself to CMS's attention if you fail to respond to Comprehensive Er... Read more
Industry Notes:
Help Is Available For Comparative Billing Reports
Wondering what to make of the comparative billing report you received from CBR contractor... Read more
Industry Notes:
Tap These Free Tools For Doc, Bene Education
Medicare officials have put more physician and beneficiary training tools at your fingert... Read more
Industry Notes:
FBI Searches Office Of Minnesota HHA
Medicaid's home health fraud hunt is showing more results. In Minnesota, the FBI has sear... Read more
Industry Notes:
HHA Chain Teams Up With Texas Hospital
Regional chain LHC Group Inc. has entered into a home health joint venture with CHRISTUS ... Read more
What Do You Think?:
Could 'Willful Neglect'Violations Apply To Stolen Laptop?
It could happen, says HIPAA expert. Willful neglect violations can lead to some humongous... Read more
Regulations:
FFE Burden Crushes HHAs
Docs get inconsistent messages about the new face-to-face requirement. Getting physicians... Read more
Compliance:
Access Problems Loom Due To FFE
Many HHAs opt to deny admission if FFE visits and forms aren't in place. Once enforcement... Read more
Documentation:
FFE Documentation Presents Complications
Many providers fear that some physicians will stop referring home care patients, based on ... Read more
Strategy:
Use These 11 Tips To Tackle FFE Requirement
Reach out to variety of sources for education. The new face-to-face encounter requirem... Read more
Budget:
President's Budget Gives Home Care A Break
Industry still faces an uphill battle in this budget-cutting year. Home health agencies b... Read more
Industry Notes:
Get Your Physician Orders, Signatures Right
Documentation second-biggest problem for HHAs, latest CERT review shows. With medical rev... Read more
Industry Notes:
Don't Let Response-Specific Instructions Lead You Astray
Beware an error in the latest OASIS-C guidance from the Centers for Medicare & Medica... Read more
Industry Notes:
Home Therapy As Effective As Locomotor Therapy
You may receive more referrals for stroke patients requiring therapy, thanks to a new stu... Read more
Industry Notes:
Oxygen Pay Rates Should Be Lower, GAO Tells Congress In New Report
Oxygen suppliers will see Medicare reimbursement rates for the equipment fall even furthe... Read more
Industry Notes:
Another Claims System Fix On Deck For March
If you have claims spanning from 2009 to 2010 that are editing incorrectly for timeliness... Read more
Industry Notes:
Campaign To Repeal New 1099 Tax Reporting For Small Biz Continues
The campaign against new 1099 reporting rules continues. The House Committee on Small Bus... Read more
Industry Notes:
FBI Says Home Care Fraud Investigations Are On The Rise
Home care fraud investigations are on the rise, increasing your chances of getting caught... Read more
Industry Notes:
Tip: Check This If Your Adjustments Aren't Working
If you're wondering why your claims adjustments won't work, you might have to check where... Read more
Therapy:
Use These 7 Steps To Succeed With New Therapy Changes
Your therapy retooling process should already be in full swing. Don't wait until the last... Read more
Compliance:
5 Tips Help You Keep Compliance Problems At Bay
How often do you review your compliance plan? It seems like not even a week can go by wit... Read more
Education:
Get Training On Face-To-Face, Therapy Changes And More
Check out Eli audioconferences on the PPS 2011’s rule many provisions and other to... Read more
Regulations:
Add One More Notice To Patients' Paperwork Mountain
QIO complaint process newest notification requirement proposed. In addition to all the ot... Read more
Industry Notes:
Home Health Fraud Grabs The Spotlight
Warning: Frontline workers aren't immune from fraud charges. Two splashy fraud stories ab... Read more
Industry Notes:
New Year's Claims System Problems Continue
Add another claims payment system problem to the list, and this one may require effort on... Read more
Industry Notes:
OIG Launches Most Wanted List
Move over, America's Most Wanted. The HHS Office of Inspector General has its own list of... Read more
Industry Notes:
Providers Throng OIG Compliance Sessions
If you missed signing up for the OIG's recently announced compliance training seminars, i... Read more
Industry Notes:
Cahaba-To-CIGNA Transition Rolls Forward
The transition from regional home health intermediary Cahaba GBA to HHH MAC CIGNA continu... Read more
Industry Notes:
New HH PPS Pricer Available Online
You can download the latest version of the Home Health PPS (HH PPS) PC Pricer at www.cms.... Read more
Industry Notes:
Media Praises Home Care For Snowstorm Efforts
Home care workers of one Missouri agency got recognition for their extraordinary efforts ... Read more
Industry Notes:
LHC Takes On Florida Hospital Agency
Lafayette, La.-based chain LHC Group Inc. has entered into a home health joint venture wi... Read more
Industry Notes:
Tennessee Hospital Plans Home Care Sale
Claiborne County Hospital in Tazewell, Tenn. plans to sell its home care unit, Claiborne ... Read more
Industry Notes:
Apria To Buy Praxair's U.S. Oxygen Business
More of your patients may be getting oxygen from Apria. Lake Forest, Calif.-based giant A... Read more
Reader Question:
Calm Employees' Fears About Compliance Focus
Let this FAQ help you troubleshoot your compliance measures. Check out the answer to one ... Read more
Therapy:
Tackle Your Biggest Therapy Challenge Under New Requirements: Visit Timing
Therapists must learn to document better in many cases. Don’t let your focus on ... Read more
Regulations:
These Therapy Changes To Hit April 1
It's no April Fool's Day joke -- the Centers for Medicare & Medicaid Services fin... Read more
Compliance:
Count Your Therapy Visits Using These Rules
Warning: Don't count on visit range. Are you confused about when to have therapists condu... Read more
Hospice:
New JAMA Study Indicts For-Profit Hospices
Study highlights fissures within hospice industry. A new article in the Journal of the Am... Read more
OASIS:
OASIS Manual Update May Change Your Ulcer Coding
Prepare for ulcer coding conflict between OASIS, ICD-9 guidance. Coding for ulcers is nev... Read more
Industry Notes:
Legislation Aims To Abolish 'Super-MedPAC'
Republicans also target 1099 reporting burden. The only thing standing between you and de... Read more
Industry Notes:
Tougher Enrollment Processes, Payment Suspensions Finalized.
Get ready for beefed up screening for your Medicare enrollment. The HHS Office of Inspect... Read more
Industry Notes:
Don't Bill April 1 Without Face To Face Requirements
If you bill for an episode without all the required face to face encounter documentation,... Read more
Industry Notes:
Medicaid Home Care Funding Under Fire In States
Medicaid home care spending is at grave risk in many states as they look for ways to slas... Read more
Industry Notes:
Keep Tabs On Growing List Of Claims Glitches
The laundry list of claims payment glitches continues to grow. Case in point: "Claims tha... Read more
Industry Notes:
OIG Compliance Training Offers Peek At Feds' View
You may want to hop on an opportunity to prepare for a visit from the feds. The HHS Offic... Read more
Industry Notes:
Use This New HHH MAC's Number For DDE
Don't forget to use your new contractor number for Palmetto GBA, now that it has become t... Read more
Industry Notes:
AccentCare Gets Ready For More Growth
You can expect more growth from Irvine, Calif.-based AccentCare Inc., which recently acqu... Read more
Compliance:
Physicians Balk At Face To Face Burden
Home care providers question CMS's education effort for docs on the new requirement. The ... Read more
Reimbursement:
Choose New G Codes Correctly
Tip: Remember to use only one G code per visit. You'll need to keep your billing precise ... Read more
Regulations:
Get Your Next CAHPS Exception Form In Soon
CMS also reveals PECOS backlog in forum. Don't rest on your laurels if you're exempt from... Read more
Fraud & Abuse:
Feds Take Aim At HHA Fraud
Predictive modeling could put your claims under intense scrutiny. The home health agency ... Read more
Contractors:
New MAC Takes Over From Cahaba In June
Palmetto transition goes smoothly, new HHH MAC says. CIGNA Government Services has announ... Read more
Industry Notes:
New Claims System Update Brings New Problems
Watch out for these reimbursement-draining payment glitches. If your claims are getting u... Read more
Human Resources:
Use 4 Leadership Qualities To Improve Your Supervising
Tip: Hone your negotiation skills, expert urges. What are the qualities of a good leader?... Read more
Industry Notes:
Get To Know New Key Congressional Members
Home care providers may be getting used to some new names this congressional session, as ... Read more
Industry Notes:
CMS Delays Expansion Of DME Direct Solicitation Ban
CMS is holding off on its expansion of the direct solicitation ban for durable medical eq... Read more
Industry Notes:
Home Oxygen Approved For Cluster Headaches In Trials
CMS has some good news for your patients battling cluster headaches (CH). "After careful ... Read more
Industry Notes:
New Law: NY Patients Get End Of Life Counseling
Hospices in New York may soon see if more education will lead to better utilization of th... Read more
Industry Notes:
Potential HHA Copay Will Hurt Seniors
Apotential home health copayment continues to garner mainstream press attention, and indu... Read more
Industry Notes:
Assess 36-Month Rule For Transactions, Experts Warn
If you hope to squeeze into an exception in the so-called 36-month rule to avoid a new en... Read more
Industry Notes:
Hospices Forge Ahead With Facility Development
An uncertain reimbursement future isn't putting the brakes on hospice facility growth. Fo... Read more
Prospective Payment System:
MedPAC Wants A Copay In Your Future
Payment commission paints industry with broad fraud brush. If an influential advisory bod... Read more
Reimbursement:
Home Care Industry Vows To Fight Copay
Get ready for 'copay wars.' A home health agency copayment wouldn't just be bad for provi... Read more
Diagnosis Coding:
Get Started On Your ICD-10 Transition Before It's Too Late
Providers 'surprised' by how all-encompassing ICD-10 transition is, CMS rep says. With al... Read more
ICD-10:
Use Diagnosis Crosswalks To Ease ICD-10 Transition
You'll benefit from the new code set, which includes 2011 diagnoses. In its attempt to ma... Read more
Industry Notes:
MedPAC Calls For 1% Increase To Hospice Payments
Medicare hospice spending has increased 300% over seven years. Hospices would see a 1 per... Read more
Industry Notes:
Consult 11 New Face To Face FAQs
The face to face encounter requirement is causing HHAs and hospices massive confusion as t... Read more
Industry Notes:
Lawsuit Challenges 'Improvement' Criteria
Aclass action lawsuit on behalf of Medicare beneficiaries could liberalize home care cover... Read more
Industry Notes:
Use These Factors In Fall Assessments
Updated fall risk guidelines from the American Geriatrics Society will apply to your patie... Read more
Industry Notes:
Report Your DME Bidding Concerns Here
"No news is bad news" regarding durable medical equipment competitive bidding, says the Na... Read more
Industry Notes:
Intermediary Provides G Code Guidance
Have questions about using the new G codes on your HHA claims? Updated billing resources f... Read more
Industry Notes:
Home Care Saves Billions, New Study Says
The rise of home care has saved the nation tens of billions of dollars a year, and it will... Read more
Industry Notes:
Payment System Glitch Corrected, RHHI Reports
Your trouble with Reason Code 34919 should soon be over. After the January update to the M... Read more
Industry Notes:
Check OIG Excluded List Or Risk Whopping Penalty
Don't forget to check your employees against the OIG's exclusion list. In November, Long T... Read more
Industry Notes:
Palmetto MAC Transition Requires Claim Change For You
Starting Jan. 24, Palmetto GBA will go from your RHHI to your HHH MAC. Home care providers... Read more
Reader Question:
Say Yes To At-Home Outpatient Treatment -- Sometimes
Tip: For Part B therapy, document why you're furnishing it in the home. Question: Can we ... Read more
Regulations:
Don't Waste Your Face To Face Encounter Delay Time
Just because CMS postponed enforcement doesn't mean you get a 3-month free pass. Working ... Read more
Compliance:
FFE FAQs Contain Good News
New guidance from Medicare sheds light on thorny face to face encounter issues. Your Medi... Read more
Managed Care:
Overcome Delinquent Payor Headaches By Knowing Your State's Prompt Pay Laws
Remember: Medicare requires contractors to pay your clean claims within 30 days, but priv... Read more
Managed Care:
Hold Your Payors Accountable
If your private payors consistently lag on paying claims and fail to meet prompt pay law ... Read more
Fraud & Abuse:
OIG Focuses On Payment Errors, Missing Doc NPIs
Watchdog agency's semiannual report to Congress highlights target areas. Wondering whethe... Read more
Industry Notes:
Your PS&R Clock May Be About To Run Out
Don't let PS&R registration delays doom your cost report. If your fiscal year just en... Read more
Industry Notes:
Home Care Spending Grows 10%, New Spending Report Shows
General health care spending may have slowed in 2009, but home care spending did just the... Read more
Industry Notes:
Beware New Payment Glitches
Claims system changes have given rise to payment problems in the new year. "Home health R... Read more
Industry Notes:
Help Hospitals With Readmissions For P4P
Hospitals soon may have extra incentive to line up home care services for their discharge... Read more
Industry Notes:
Doc Claim Edits May Help Your PECOS Edit Efforts
Physicians may not be paving the way for your PECOS edits that start in July, but at leas... Read more
Industry Notes:
Cross These Items Off Your Hospice To-Do List
Hospices have two less things to worry about, thanks to Palmetto GBA's question and answe... Read more
Industry Notes:
Home Care Can Help Medicaid Cut Costs
Home care providers' Medicaid business is looking grim, thanks to states' efforts to cut ... Read more
Industry Notes:
New NHIC Hospice Job Aids Target Elections, Revocations
Need help understanding your duties with hospice notices of election and revocation? Home... Read more
Industry Notes:
Hospice Use Grows For Dementia SNF Patients
A growing number of nursing home residents with dementia are tapping the hospice benefit,... Read more
Reader Question:
Are Overpayments Putting Your Agency At Risk?
Do you have patients that pay copays? Keep close track or risk False Claims Act penalties... Read more
Reimbursement:
MedPAC To Vote On Home Health Recs This Week
Will a copay make it onto the commission's influential to-do list for Congress? The fate ... Read more
Know Your Facts:
HHA Numbers Have Exceeded 1990s Highs
Growth is concentrated in Florida, Texas. Here are the stats the Medicare Payment Advisor... Read more
Marketing:
Use A Well-Networked Web Presence For Savvy Marketing
The old web rules no longer apply. If you don't have a multi-faceted online strategy, you... Read more
Strategy:
Use These 4 Strategies For Souping Up Your Website
This advice will help increase the value of your online offerings. A multi-media web stra... Read more
Contractors:
Intermediary-To-MAC Transition Set For This Month
Use this new payer ID number by the deadline or lose payment. You might think you don't n... Read more
Industry Notes:
Chains Ramp Up Acquisitions
Uncertain reimbursement future fails to put a damper on the M&A market. The home care... Read more
Industry Notes:
Non-contract durable medical equipment
• Non-contract durable medical equipment suppliers in competitive bidding areas who deci... Read more
Industry Notes:
If you've been wondering how to bill
If you've been wondering how to bill for your hospice patients when they enter VA faciliti... Read more
Industry Notes:
With the new year comes
With the new year comes a new claims filing deadline. "All claims for services furnished o... Read more
Industry Notes:
Health and Human Services Secretary
Health and Human Services Secretary Kathleen Sebelius applauded HHS's stepped-up fraud fig... Read more
Industry Notes:
Having trouble navigating in DDE?
Having trouble navigating in DDE? You're in good company. Problem: "There is an issue with... Read more
Industry Notes:
You've got a new process to resolve billing disputes
You've got a new process to resolve billing disputes with other providers if Palmetto GBA ... Read more
Industry Notes:
Hold onto your wallets if your mileage reimbursement rates are tied
Hold onto your wallets if your mileage reimbursement rates are tied to current gas prices.... Read more
Industry Notes:
The feds continue to see benefits
The feds continue to see benefits from threatening providers with False Claims Act lawsuit... Read more
Regulations:
CMS Delays Face To Face Enforcement
11th hour reprieve granted on burdensome new physician encounter requirement. Home health... Read more
Education:
Tap These FFE Resources To Make Your Transition Easier
CMS issues new set of questions and answers on face to face encounters. You don't have to... Read more
Privacy:
Red Flags Exemption Doesn't Give You A Pass On Safeguards
Consider keeping many of your identify theft precautions in place. On Dec. 18, President ... Read more
Enforcement:
Watch Out: Feds Ramp Up False Claims Lawsuits
Threat of FCA lawsuits causes providers to settle. There's a troubling new trend growing&... Read more
Compliance:
3 Reasons Providers Fear the False Claims Act
This statute creates an uneven playing field that recently got bigger. Finding out that y... Read more
Industry Notes:
Government Ramps Up Predictive Modeling To Fight Fraud
Legit providers hope they don't get swept up in the analytical dragnet. The government's ... Read more
Industry Notes:
Use This Rule To Bill The Correct New G Code
You've got a little more guidance to help you choose the right G code for your claims sta... Read more
Industry Notes:
Hospice Comparative Billing Reports On The Way
Hospices have about a 50/50 chance of receiving information on their billing patterns fro... Read more
Industry Notes:
Use This Tool To Locate Contract Bidders
Durable medical equipment suppliers' efforts to delay or cancel competitive bidding were ... Read more
Industry Notes:
Intermediary Adjusts Doc Date Stamp Expiration
You're getting a bit of breathing room on the new physician signature requirements if Cah... Read more
Industry Notes:
Therapy, Inhalation Drugs Cause More Trouble In Miami
Miami continues to have a high fraud risk profile for Medicare providers. Per-beneficiary... Read more
Industry Notes:
Investors Make Buys In Home Care Market
Reimbursement and regulatory uncertainty isn't keeping investors out of the home care acq... Read more
Industry Notes:
2011 Mileage Rate Up Slightly To 52 Cents
The new 2011 mileage rate from the Internal Revenue Service is 51 cents per mile. That's ... Read more
Industry Notes:
Looking For Vaccination Billing Info? Try This New Tool
If you're looking for quick billing information on vaccinations, check out a new resource... Read more
Available Years:  2011  2010  2009  2008  2007  2006  2005  2004  2003