Home Health & Hospice Week

Therapy, outliers pose audit threat. The new Recovery Audit Contractors haven't announced their specific activities for home health agencies and hospices yet, but industry experts expect to see these areas targeted as low-hanging fruit: • Therapy. "One of the easiest targets for the RAC audits would be therapy, since it has a direct measurable impact on payment," predicts consultant M. Aaron Little with BKD in Springfield, Mo. For example: Just one denied therapy visit can cost you $600 if you go from six to five visits. • High reimbursement outliers. "RACs will likely look first at ... providers outside the norm,"expects consultant Tom Boyd with Rohnert Park, Calif.-based Boyd & Nicholas. For instance, an HHA with an average payment of $4,500 per episode when its neighbors typically see $3,000 will raise red flags, Boyd tells Eli. • High utilization outliers. It won't just be dollars that attract RACs' attention, Boyd [...]