OASIS Alert

Published on Mon Jan 14, 2013 PDF

Scheduling mishaps are but one hazard for your agency to avoid when it comes to patient recertifications.

HHAs must also take care when it comes to filling out new episode and recertification dates on the OASIS assessment form, urges Rose Kimball, a consultant with Med-Care Administrative Services in Dallas.

Kimball reminds agencies that the OASIS tool is a “thru-date” form, meaning that recertification periods extend thru the 60th day from the start of care date, rather than simply  ending after day-59. Conversely, a new episode start date could not occur before that 60th date, but only on the 61st day or later.

To illustrate, Kimball describes an OASIS assessment with an Oct. 15 start of care date. According to collection guidelines, a date of Dec. 13 — which represents 60 days  from the SOC date — would be accepted only as a recertification date, and not as the start of a new episode. In this example, then, Kimball states that a Dec. 13 date would be permitted in M0090, but not in M0032.

Agencies also must be sure to maintain quality documentation regarding recertifications, advises Pam Warmack, a consultant with Ruston, LAbased Clinic Connections.

“In order to recertify, there needs to be clinical evidence that makes that decision appropriate in the event that the chart is audited,” she asserts. If the patient’s documentation  is deficient, an auditor won’t readily see why an HHA should be reimbursed for the recertification.