It may seem that the clinical documentation detail expected by this judge is excessive. Nevertheless, had the clinicians and case managers serving this patient delivered that extra detail, the episode would have been paid and the appeals process would have been unnecessary.
Achieving and maintaining compliance has always been high on the goal statements of every legitimate home care agency. Today, compliance is quickly becoming a survival issue. To help readers sort through current challenges, we traveled to Boston to interview Denise Bonn, Deputy Director of NAHC’s Center for Healthcare law.
There was never a question that this Congestive Heart Failure patient was homebound and eligible for the Medicare home health benefit. If the Stasis ulcer on her leg was not serious enough to keep her mostly bedridden, her 103-year old, failing heart certainly restricted her ability to get out and about without “considerable and taxing effort.”
The result: Medicare home care services for this patient, at a cost to taxpayers of approximately $65 per day, have been replaced by institutional care, at roughly four times that cost to the government.
How to manage is the third component of the P-E-M approach to dealing with RACs. It may be inevitable that hospices, perhaps yours, will eventually receive a demand letter or request for records from the contractor at work in your region. As soon as a communication from a RAC is received, time is of the […]
The very best, and maybe only, defense against Recovery Audit Contractor attacks against your payments is education. The P-E-M strategy for dealing with RACs focuses on education on two levels: Learn everything possible about what RACs do, who they are and what to expect from them; and Make absolutely certain that all of the hospice’s clinical […]
The first component of the P-E-M approach for dealing with Recovery Audit Contractors is to prepare. Preparation for RACs includes conducting a baseline compliance audit to assess a hospice’s vulnerability and risk. It also includes getting ready for “RAC attacks” by making certain appropriate personnel are assigned key responsibilities essential to building a RAC infrastructure. This may already be in […]
RAC Assistance for Hospices is an educational service in newsletter form provided by Weatherbee Resources, Inc. to help hospices deal with the scrutiny conducted by Recovery Audit Contractors (RACs). In addition, one of the goals of RAC Assistance for Hospice is to monitor and assess the impact of the RACs on hospices across the country. […]
Home care’s original and best-known technology journal has evolved into a bigger and better format. Read editor Tim Rowan’s welcome letter and explanation of what to expect from “Home Care Tech Report.”
Once exclusively involved on the disease management side of healthcare, Cardiocom® has recently been making a name for itself within home care and hospice. During July, the Chanhassen, Minnesota home telehealth manufacturer and vendor announced three major new contracts.
On June 25, a New Hampshire RN filed a civil suit against three officials of the Obama Administration alleging the American Recovery and Reinvestment Act’s (ARRA) health IT provisions violate HIPAA privacy provisions. The suit, filed by the nurse’s attorney husband, expresses fears that the stimulus funds will weaken HIPAA privacy safeguards and allow the government to dictate care plans to physicians.
