OASIS Alert

Reader Question:

OASIS Assessment Crucial To Medicare Payment Process

Question: We have a patient we have only been seeing under the Medicaid Waiver for aide services, so no OASIS assessment was done. There has been no significant change in the patient's condition, but now the physician has decided the patient needs to have therapy services. Do we need to do an OASIS assessment when the therapy services begin, or do we wait for the next recert to do the assessment?

Answer: You definitely need to do a start of care OASIS assessment when the therapy starts, says clinical consultant Lisa Selman-Holman with Denton, TX-based Selman-Holman & Associates. Regardless of whether Medicaid or Medicare is the payor, you must do a start of care OASIS assessment once you begin skilled services. Not doing this would be a survey deficiency, she adds.

Remember, for your agency to bill the claim to Medicare, you must have a home health resource group to determine the payment amount. This number comes directly from the OASIS assessment.