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Medicare home health billing is a complicated and very specialized process. There are frequent changes in billing regulations which makes home health reimbursements a real nightmare sometimes. Home health billing is a logical process with many checks and balances; however, errors are not uncommon and often result in denied claims and lost revenue amounting to billions of dollars every year for home health agencies. More often than not, duplicate entries cause compliance issues and considerably slow down the billing process.
Understanding the Medicare home health billing system is the key to getting proper reimbursement. Don’t let duplicate claims wreak havoc on your reimbursements. Follow these simple steps to avoid some common home health billing mistakes:
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Incorrect Information: Conflicting information on the Request for Additional Payment (RAP) and final claim can compromise your reimbursement. The admission date and Health Insurance Prospective Payment System (HIPPS) code are two frequent culprits, or the Health Insurance Claim Number (HICN) may have been corrected.
Cancels: If you submit incorrect information on a RAP, you must cancel the RAP and submit a new one.
Autocancels: If the claims system auto-cancelled your RAP because you took too long to submit a final claim, it isn’t entirely erased from the Common Working File (CWF).
Adjustments: When two final claims have been submitted, HHAs should submit an adjustment (type of bill 3X7) instead of a duplicate final claim to fix errors.
Hold Off: Submitting a second RAP will not help if your claim was rejected. Instead, send the relevant materials to the correct department at the Regional Home Health Intermediary (RHHI), and it will determine how to process the RAP.
Make yourself aware of the Medicare home health billing complexities and analyze your entire billing data for any opportunity that you can lay reimbursement claim upon.
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Assessment Before signing a contract with a home health care agency, an assessment will be made to determine the needs of the person who requires care, since a physician’s prescription for home health will not fully outline all your needs. Many companies offer this service for free. During an assessment an agency representative from an agency will visit your loved one in the home or at the hospital. The agency representative will ask questions and look around the house if needed. The following issues should be assessed by both interview and observation: * Physical health * Medication use * Amount of aid needed with ADLs or IADLs * Mental health * Home safety * Quality of life The idea behind an assessment is to figure out what your loved one requires on a basic health and safety level, while maintaining a high quality of life. Care Plan The assessment provides the basis for a care plan. A care plan is a document that explains the client’s needs, and how to meet them. A care plan should be reassessed by an agency on a monthly basis and as needed. A care plan: * Increases consistency of care (this is exceptionally important when multiple caregivers must interact with each other) * Sets priorities and goals for an individual’s care * Acts as a reference to aid in measuring an individual’s progress Contract Home health care agencies will have you sign a contract. These contracts can be changed and amended, so before signing it, think about whether there are certain verbal promises that should be written into the contract. For example, if an agency promises you that a replacement caregiver will be provided within a certain time-frame if the primary caregiver is sick or must be absent for a day, you may want to have the agency add that detail to the contract.
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There may come a time when you will face the fact that your elderly loved ones require a bit of assistance, especially when cognitive and/or physical abilities begin to fail. It’s not an easy decision to make, but once you decide that your loved one requires senior home care, it’s time to find someone to help out. If you and other family members live within a short distance, it’s possible that you could work out a simple schedule for stopping in and visiting with your loved one on a daily basis. If that is not possible, you’ll need to consider one of the following options:
Do you know of a trusted and reliable neighbor, friend, or even distant relative who could stop in and check on your loved one during the day?
Is there a reputable non-profit organization or for-profit business in the area that could assist your loved one? This could prove to be a real challenge if you’re not living in close proximity to your aging parent(s).
Or, perhaps you need to consider having your loved one move into your home with you so you can watch over them and help them daily with whatever it is they need?
Types of Senior Home Care Services
Before making any decisions about home care for your parent(s), it’s a good idea to know what services are available. This way, you can make a more educated and confident decision.
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Non-medical In-Home Care – someone would visit the home each day and provide basic services that might include housekeeping, cleaning, cooking, bathing, getting dressed, or helping with other chores as needed.
In-Home Medical Care – this is a similar service as mentioned above, but means that a person who holds a medical certification of some kind would be visiting the home on a daily basis. This type of home care would include tasks such as helping with blood pressure, administering medications, and other monitoring services.
Concierge Services – someone would shop for and drop off items for your parent(s).
Companion Services – someone would be hired to move in with your parent and provide full-time services (many of which are listed above).
Nursing Care – this type of senior home care can be secured on a full-time or a part-time basis.
How To Locate and Decide on Senior Home Care Providers
It’s no easy task to choose just the right type of home care for your parent, but here are some helpful resources that should make the process a bit smoother and perhaps easier for you.
This locator guide from Assist Guide Information Services may be helpful for finding a reputable home care service near your parents’ home. The Family Care Navigator is a helpful site for locating home health care. And of course, Medicare’s providers site could be helpful as well.
Make sure to refer to the checklist provided by AARP as you consider each possible home care service. Read over this checklist of Do’s and Don’ts when working through the process. You’ll want to get references from others who have used the service you’re considering to make sure they were trustworthy, compassionate, and competent.
How to Pay for Home Care Services
These services are not inexpensive, but there is a lot of financial help available to you. This way, your parent(s) can stay in their home where they are most familiar and comfortable. Check out the Benefits Guide for Seniors and Eldercare Locator.
We would appreciate hearing about any additional resources that you’ve found to be helpful during your search for a home care service provider.
Oh, you may find this downloadable calendar from Lotsa Helping Hands to be a great organizational tool.
The Ol’ Boomer was born in 1949 with over 60 years experience as a Baby Boomer and Host of The-Baby-Boomers-Webplace.com. Visit us for more information on senior health care
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