Advanced Search

Home Health & Hospice Week

Reimbursement:

Minimize Your Outlier Risk With These 7 Steps

Published on Wed Nov 11, 2009

Discharging patients may open you up to abandonment charges. Tough times are ahead for home health agencies affected by the 10 percent outlier cap. Here are steps you can take to mitigate the policy's impact on your agency: 1. Assess your vulnerability. The 10 percent per agency cap will start applying immediately in January (see related story, p. 330). That means you need to find out right away if your payments will be limited, recommends Abilene, Texas-based financial consultant Bobby Dusek. "An agency can look at their total outlier payments as a percentage of their total reimbursement to see if they might have a problem," Dusek advises. Since the cap will affect episodes that have already begun, "agencies need to look at their situation now," he stresses. Remember: "It is only the outlier add-on that is capped, not the underlying HHRG payment for the episode," Dusek adds. Clients of consultant [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Home Health & Hospice Week

View All