Medicare is now poised to do a better job at reviewing home health care agency payment claims through its new initiative called Review Choice Demonstration. Illinois is the first state to start this new claim review process, starting June 1st, 2019. Other states will follow in the coming year, with an unspecified final rollout date for across the United States.
The choice part of Review Choice Demonstration is the option to choose how CMS will review your home health care agency’s Medicare claims. With this new policy, home health care agencies can elect to either have CMS review their claims on a pre-claim basis or post-claim. There is also a minimum review choice, although choosing the minimum review comes with an automatic 25% reduction in reimbursement. So far, none of the home health care agencies in Illinois have selected the minimum review option for obvious reasons.
The stricter claim reviews are designed to catch claims from substandard home health care agencies early on. With good reason, the whopping total for poor home health Medicare billing, came to around 3.2 Billion dollars, according to the Government Accountability Office (GAO).
Home Health Care Agencies Must Focus On Record Keeping
The old adage “If it isn’t written down, it didn’t happen,” stands more in the medical record space than any other. Home health care workers must focus on diligently on keeping excellent notes on the care they provide to their clients. Many reputable home health care agencies, as well as many other businesses in the medical space, have lost hard-earned dollars in repayments to Medicare simply because the correct documentation failed to be produced upon Medicare claim reviews.
It is unnerving to see Medicare payments be redacted when you know quality care was given. There is more home health care agencies can do to ensure that Medicare repayments can be kept to an absolute minimum going forward.
Train Your Staff On Client Note Writing -It is easy to fault the one who didn’t take proper notes when it comes to Medicare repayments, but the genesis of the problem may lie in accurate and thorough client note taking. It is one thing to teach a professional caregiver how to fill in all of the right spaces on your home health care agency’s forms but another to train them on what kinds of information are necessary to include to prepare the client record for proper billing.
Educate your staff on what is needed for Medicare to approve your home healthcare agency’s service claims. Supervisors should also be checking paperwork at the end of the day or week to ensure that everything needed for proper billing is in place before it hits their billing department’s inbox.
“You have to have good processes in place, with staff buying into what you’re trying to accomplish,” Cheryl Adams, the home health administrator for Sparta Community Hospital, told Home Health Care News.
State Up To Date On Medicare Billing Regulations And Rules - It helps to make sure you are always keeping apprised of any new CMS regulations and rule changes. Keep reviewing the billing procedures as if you are reading them for the first time. Make sure you are reading any emails that come from CMS regarding Medicare billing. Too many medical providers have faced poor audit results because they let CMS emails go by without reading them thoroughly. Treat CMS correspondence likes your company’s future depends on it. In fact, it just might!
Use A Record Keeping System That Everyone Can Use - Good start to great Medicare CMS reviews starts with a client record keeping system that is easy to use and goes wherever your professional caregiver does. Many smaller home health care agencies use paper forms and manilla folders to keep track of information. This outdated and unsecured system leaves home health care agencies at risk of missing the necessary documentation needed for proper billing. A HIPAA compliant, digital format, with tablet capabilities, brings the recordkeeping system to the staff who need to use it for notes and paperwork. Don’t let things get lost, use the kinds of tools in today’s market that enable excellent recordkeeping to begin today and continue working into the future.
Client Care Coordination Is The Future Of Good Medicare Reviews
Care coordination is more than scheduling services. It means that everyone involved in the client’s care from medical staff to professional caregivers and even family members can see all of the necessary documentation, any client or medical notes, anything and everything essential to keep an excellent standard of care and accurate recordkeeping for Medicare billing.
What kind of system does all of the recommended functions, as well as provides an excellent way to provide client care coordination? eCare Vault. It is the first platform of its kind to bring client record keeping and care coordination together for the best possible outcomes. It’s effective communication for caregivers and home health care agency staff, and great note keeping needed for proper billing. What else could you need? While many home health care agencies are scrambling to find a solution to stricter Medicare claim reviews, eCare Vault clients know they’ve got the only solution that matters in Review Choice Demonstration. If you would like your own demo on how eCare Vault can help your home health care agency with Review Choice Demonstration management, contact us today.