by Heather Wilson I had the opportunity to speak with a hospice executive director this week who stopped by the Weatherbee offices for a visit during her vacation/workshop on Cape Cod. She talked about how challenging it is to keep up with issues like the RACs given the amount of information she needs to absorb […]
We may not always have a Medically Unbelievable Denial story to offer every week but this one could not wait until next month. This episode was denied, in part, because “home health care agencies are paid more when they provide more therapy services.”
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, and sit in on her comprehensive […]
Welcome to “RAC Assistance for Home Care,” a “Home Health News Source” publication. Read our Mission Statement here.
The U.S. Department of Health and Human Services will host a telephone conference on Thursday, August 20 to provide information for healthcare providers about the H1N1 Virus Title: Information Exchange with HHS on H1N1 Healthcare System Preparedness and Response Date: Thursday, August 20, 2009 Time: 1:30 -3:00 pm, EDT Call-in Number: 800-837-1935 Conference ID: H1N1 […]
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The result: Medicare home care services for this patient, at a cost to taxpayers of approximately $65 per day, have been replaced by institutional care, at roughly four times that cost to the government.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 […]
