Home Health & Hospice Week

5 tips for billing under the new OASIS requirements.

Sticking with the old version of HAVEN may not be the best choice for home health agencies under the new OASIS reporting requirements.

To avoid having to submit OASIS data frequently, the Centers for Medicare & Medicaid Services gives home health agencies three options and one short-term alternative in new instructions released June 20.

Savvy HHAs will choose Option 1 or Option 3, experts tell Eli. Option 2, sticking with the old HAVEN software, "is the easiest since the agency merely continues to use OASIS data as it has in the past," admits Abilene, TX-based consultant Bobby Dusek. "How-ever, the loss of the new edits and possible complications could result in more time and effort than changing now," Dusek warns.

And agencies will have to switch to new software in 11 months, when the NPI is required. "Why not make the change now?" Dusek asks.

Top pick: Option 1, using non-HAVEN software that continues to lock assessments, will probably be the most popular choice. Under that selection, providers will need few if any changes to processes, observes consultant M. Aaron Little with BKD in Springfield, MO. "And software vendors don't need to scramble making programming changes."

"Option 1 will probably be used by all agencies that currently use commercial billing software," Dusek expects.

Good alternative: Agencies that use HAVEN software will have only minor changes to make if they use the new version, HAVEN 7.0, Dusek says. That's because the software retains the "Locked (Export Ready)" feature.

Most providers merely will have to change their polices to read that instead of "locking" OASIS prior to RAP submission, OASIS is in the "Locked (Export Ready)" status, Dusek predicts.

5 Steps To Succeed At OASIS and Billing

Little offers these tips for billing under the new OASIS requirements:

1. Emphasize the lock requirement. Even though Medicare no longer requires a seven-day lock, "make certain both billing and clinical staff understand the importance of finalizing the OASIS," Little advises.

And make sure clinicians notify billers promptly once OASIS is ready. Poor communication means you're risking slow or missed billing or being out of compliance by billing without the required OASIS lock.

2. Keep a deadline. Consider implementing a seven- to 10-day deadline for finalizing OASIS data. Numerous providers haven't shared the lock date elimination news with their clinical staff so they can continue under the seven-day timeframe, they say.

3. Encourage care coordination. Don't let one discipline hold up your OASIS data and billing.
 
"Examine current coordination of care practices to ensure that nurses and therapists are coordinating in a timely manner on the completion of the OASIS," Little urges.

4. Keep tabs on RAPs. Compare the number of RAPs billed to the number of admissions and recertifications to ensure they've all been billed, Little counsels. Check them periodically throughout the month, then reconcile the final numbers at the end of the month.

5. Investigate stragglers. Track RAPs that haven't been billed timely and find out why the OASIS data hasn't been finalized.