Volume 4, Number 44 December  16, 2015



Dear Healthcare at Home Colleague,

We make a sincere attempt to balance our news and feature articles between Private Duty and Medicare/Medicaid home healthcare agencies, in order to meet everyone's needs. This week, we focus on a situation that is causing great concern to owners and administrators of certified agencies. Medicare Administrative Contractors have stepped up their efforts to find reasons to deny claims. At the same time Zone Program Integrity Contractors are issuing more ADRs and recouping more payments.

This week, we devote this entire issue to an exploration of the justifications these contractors use for denying and recouping payments, and how agencies make themselves more vulnerable to auditor probes. Essentially, it boils down to documentation that does not demonstrate medical necessity for services performed. This can include both physician and nurse written documents, and it can include homebound status affecting the entire episode as well as treatments and teachings provided at every visit.

We interviewed a number of software company executives to learn about their positions on the issue, not only about how software can help clinicians produce audit-proof documentation but whether such help is the responsibility of home health software vendors at all. You will learn that the entire Medicare improper payment rate is around 12% but that the home health rate is nearly 60%. 

And you will learn that there is not a strong consensus among software company executives about whether home care EMR software can and should help solve this problem. More than ever, we would appreciate your feedback about the three articles in this week's issue. Write to us at editor@homecaretechreport.com.

And don't forget there is still time to register to join me in Orlando at the end of January for the Executive Strategic Summit conducted by the Home Care Sales and Marketing Society. Register here and be sure to use the code HCTECH to get your 15% discount off the registration fee.

Christmas is this Friday and I want to take a moment to wish all my readers the happiest of holiday seasons. Our office will be officially closed now through January 4, but we will respond to emails once a day and return urgent phone calls. Have a terrific holiday week! Keep making a difference!

Editor signature
Tim Rowan



Payment Denial Prevention: What Is Software's Responsibility?
When Medicare contractors deny or recoup payments, where do you direct both blame and solutions, toward your clinicians or toward your software vendor?

CMS Language Most Often Used to Deny Claims
What does CMS have to say? Be familiar with the language MACs and ZPICs use as leverage to deny payments.

Software Features That Empower Clinical Best Practice
The general consensus among software company executives is that their software itself can help clinicians do their job better. We got several of them to tell us specifically what features they believe software should have to play this role.

 
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During the 1st Quarter of 2017, web sites of the above advertisers were visited by home care and hospice executives and staff 1312 times.

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Last Week's Most-Read Stories:
OCR Audits Coming, Check Your HIPAA Readiness
You have been warned.
 
Sutter Health Acquires Competitor
One of California's largest healthcare at home organizations gets larger.

As of this date, approximately 19,921,000 Baby Boomers have become Medicare eligible.



Notable Upcoming Conferences Free Webinars

Home Care Sales & Marketing Society Executive Strategic Summit * Home Care Sales and Marketing Society
January 28-29
Holiday Inn Orlando Downtown Disney
Lake Buena Vista
More information

Leading Change Together
Illinois HomeCare & Hospice Council Annual Meeting and Exposition
March 9-10
Lombard
Information and Registration


ITS' A Whole New Ballgame: 2017 Annual ConferenceMichigan Home Care & Hospice Association

May 3-5
Grand Traverse Resort
Acme, MI
Information and Registration


ICD-10 Coding Conference
Texas Association for Home Care & Hospice

Featuring Lisa Selman-Holman
September 13-14
Westin Galleria
Houston

Receive up to 11 clock or contact hours.

http://tahch.org/tahchorg/education/icd10


Public Policy Leadership Conference
Visiting Nurse Associations of America

Wednesday, September 14 at 8:00 AM through Thursday, September 15 at 3:00 PM
Washington Court Hotel
Washington, DC

More information and registration

 


By the Numbers: ICD-10 Coding Conference
Texas Association for Home Care & Hospice
September 13-14
Westin Galleria Hotel
Houston


Information and registration



By the Numbers: ICD-10 Coding Conference

Texas Association for Home Care & Hospice
September 13-14
Westin Galleria Hotel
Houston

Information and registration


HURRICANE Home Care Marketing Boot Camp 2.0 *
October 5-7
Embassy Suites Philadelphia Airport
http://homecaremarketing.net/hurricanebootcamp/

Home Care Sales and Marketing Society *
6th Annual Conference

Learn tactics and techniques for gaining more patients and clients. This year, two breakout tracks: "Field Sales Tactics" and "Internal Operational Excellence: Intake, Admissions and Inquiry."

October 6-7
Bally's Hotel and Casino
Las Vegas
Click here for more information


Annual Meeting *
National Association for Home Care and Hospice

October 23-25
Gaylord Palms Resort and Convention Center
Orlando

Information and Registration


Pre-Claim Revue Implementation
Palmetto GBA and CGS Tours Texas in Partnership with TAHC&H

Multiple Locations:
October 11 – McAllen
October 13 – San Antonio
November 16 – Houston
November 17 – Dallas
Details for each conference


The Journey Forward
South Carolina Home Care & Hospice Association Annual Conference
December 5-6
Hyatt Place + Hyatt House | Historic District
Charleston
www.schchaconferences.com

Pre-Claim Revue Seminars
Presented by QIRT
Seminars and webinars will be offered in the pilot states in advance of each state's pre-claim start date.

  • Florida seminars in September (PCR roll out date:October 1, 2016)
  • Texas seminars in November (PCR roll out date: December 1, 2016
  • Michigan and Massachusetts seminars in December (PCR roll out date: January 1, 2017)

QIRT.com


The 6th Annual Medicare Compliance Cruise *

Presented by Pearson & Bernard, PSC

January 15-22
Departs from Ft. Lauderdale
Information and registration


2017 Northeast Home Health Leadership Summit

Sponsoring Associations:

  • Connecticut Association for Healthcare at Home
  • Home Care and Hospice Alliance of Maine
  • Home Care Alliance of Massachusetts
  • Home Care Association of New Hampshire
  • Home Care and Hospice Association of New Jersey
  • Home Care Association of New York State
  • New York State Association of Health Care Providers
  • Rhode Island Partnership for Home Care
  • VNAs of Vermont

January 17-19, 2017
Colonnade Hotel
Boston

Information and Registration


OASIS-C2: The Next Steps

Texas Association for Home Care & Hospice
Presented by Lisa Selman-Holman
January 19, 2017
Westin Riverwalk Hotel

San Antonio 
Details and registration


Homecare 100 *February 4-7
Ritz-Carlton
Amelia Island, FL
Registration is full. To be added to the waiting list, contact Miriam Adams at madams@lincolnhc.com

National Leadership Conference *
Sponsored by:
Visiting Nurse Associations of America

Alliance for Home Health Quality and Innovation

April 19-21

Hilton San Diego Bayfront
https://www.homebasedcareevents.com/

Omaha System International ConferenceA Key to Practice, Documentation and Information Management
April 20-22, 2017
Eagan, MN
Bi-annual conference offers opportunities to gain knowledge about using electronic health records across diverse settings, exchanging health information, and enabling data sharing among practice, education, and research. For additional information about the conference, the call for poster abstracts and award nominations, and to register, visit www.omahasystem.org/conferences.html.
Email abstracts to lchoromanski@gillettechildrens.com

ATA Annual Meeting

American Telemedicine Association
April 23-25
Orange County Convention Center
Orlando

http://www.ata2017.org


Community Care Conference

Texas Association for Home Care & Hospice
May 9
Omni Austin Hotel Southpark

Details and registration


Pediatric Home Care Conference

Texas Association for Home Care & Hospice
May 9
Omni Austin Hotel Southpark

Details and registration


New England Home Care & Hospice Conference & Trade ShowMay 16-18
Radisson Hotel
Manchester, NH
Brochure and Registration

Annual Conference *Home Care Association of Colorado
May 17-19
Keystone Resort & Conference Center
Keystone, CO
http://www.homecareofcolorado.org


Technologies and Tactics Transforming Long-term Care Conference: Igniting Innovation and Best Practices Across the Long-term and Post-acute Care Continuum
Sponsored by TCBI and Telehealth and Medicine Today
June 30
Washington, DC
Information and registration

2017 Annual Conference and Trade Show *
Home Care Association of FloridaJuly 23-27
Renaissance Orlando at Sea World
Information and Registration

AHHC 2017 Leadership ConferenceAssociation for Home & Hospice Care of North Carolina
October 9-10
Holiday Inn Resort
Wrightsville Beach

Click here to register

Hospice Financial and Administrative Management Conference
Presented by The Health Group
November 6-7
Caribe Hilton
San Juan, Puerto Rico
Registration: conference@healthgroup.com
 

*HCTR will see you there.

Your state or national association meeting not listed? Send the details to Conferences@RowanResources.com using this format:

Conference Title
Sponsoring Association
Date(s)
Hotel or Conference Center, City, State
URL

2017 Regulatory Updates, Including Home Health Conditions of Participation

Free Webinar Hosted by DeVero Software and Relias Learning
Featured Speakers: Michael Tidd, Healthcare Synergy; Robert Love, DeVero
Tuesday, March 21
2:00 pm EDT / 11:00 am PDT

Register Here


A New Approach for Home Health Face-to-Face:
Updated Info, Updated Insights

Sponsored by Kinnser Software
Featuring Arlene Maxim, RN
Thursday, April 20
1:00 pm EDT

Learn:

  • What CMS requires for "adequate documentation" under Face-to-Face
  • How to handle inadequate progress notes provided by the physician/in-patient facility
  • Exactly what to include on your checklist of items for the physician's packet

Free: Register here



How to be the TOP DOG Sales Rep
Sponsored by PlaymakerCRM
Featuring Cheryl Peltekis, RN
December 14
2:00 EST
Register here


Grow Your Census with Online Marketing Tools

Sponsored by Shoshana Technologies

October 20
http://rosemarksystem.com



Leveraging Technology on Your Path for A 5-Star Rating

Sponsored by Brightree
Featuring Diane Link, RN, MHA, Blacktree Healthcare Consulting; Michael Puskarich, CEO, Kenosha VNA; Wendy Cofran, CIO, Natick VNA; Elaine Stephens, RN, MPH, FHHC, CEO, Walpole Area VNA

April 13
2:00 pm - 3:15 pm EDT

Learn:

  • The impact technology and process have on a 5-star rating
  • How to utilize dashboards to track and trend data that may impact outcomes
  • How to develop outcome scorecards, and how to use them during employee evaluations
  • How to utilize reports to identify educational opportunities

Free: Register here



Navigating the Final Rule for Medicare PPS for CY 2017
Sponsored by PPS Plus
Tuesday, November 15, 1:00 - 2:30 pm CST
Featuring Dave Macke, CHFP, FHFMA
Director of Reimbursement Services, VonLehman & Company
FREE

Register here


Nursing Reference Center Plus Overview
Sponsored by VNAA
Date: Every Thursday through December 8
Time: 1:30 PM Eastern
Nurses use Nursing Reference Center Plus to get answers to questions, access care plans, watch video demonstrations, strengthen nursing skills, earn continuing education credits, access drug information and patient education.
Register and attend


Why your claims are being denied:  Performing a self-assessment of your ZPIC, Pre-Claims, and VBP liabilities

Featuring Michael McGowan, CEO, OperaCare
Tuesday, January 17
2:00 p.m. EST
Cost:  $79
Register


2017 What You Need to Know about Electronic Visit Verification

EVV offers many benefits to agencies and care providers, and choosing the right solution can lead to improved operating efficiency, caregiver communication, quality of care, and client satisfaction.

Wednesday, March 15
11:00 am MST - 12:15 pm MST

Register Here



Navigating Alternative Payment Models

Presented by Mark Sharp and Raymond Belles of BKD
Tuesday, March 28
2:00 p.m. EDT
Cost: $79
Registration

 


Under Pressure — OASIS Service Utilization Review

Presented by Michael McGowan of OperaCare
Thursday, April 6
12:00 p.m. EDT
Cost: $49
Registration



What You Need To Know About Electronic Visit Verification
Presented by Darby Anderson, CDO, Addus HomeCare Corporation
Sponsored by CellTrak
Wednesday, April 12
1:00 p.m. EDT
Cost:  Complimentary
Registration link
 


Understanding the Effect Functional Scoring Has on Your Agency
Presented by Chad Whitefield, PTA, Managing Partner of Advance Rehabilitation Management Group
Thursday, April 13
2:00 p.m. EST
Cost:  $99
Registration link 


Navigating Pre-Claim Review

The controversial Pre-Claim Review Demonstration has been delayed in FL and paused in IL. So what's next? We'll cover what we've learned, what you should be doing now, and what home health care agencies can expect next.

Sponsored by Forcura
Featuring: Nick Seabrook, BlackTree Healthcare Consulting; Craig Mandeville, Forcura; Kim Gaffey, MSN, RN, Gaffey Home Nursing & Hospice
Thursday, April 13
2:00 pm EDT

Registration Link


Hospice Proposed Rule FY2018

Presented by Curaport

Featuring Katie Wehri, CHPC, Healthcare Provider Solutions
Tuesday, June 6
2:00 p.m. EDT
Cost: $89
Registration


QAPI Overview

Presented by Diane Link, BlackTree Healthcare Consulting
Tuesday, May 23rd
2:00 p.m. EST
Cost:  $99
Registration


Understanding the Effect Functional Scoring Has on Your Agency

Presented by Curaport

Featuring Chad Whitefield, PTA, Managing Partner of Advance Rehabilitation Management Group
Monday, June 12
2:00 p.m. EDT 
Cost: $59 
Registration


The Trump Effect: How the New Administration is Impacting Homecare

Presented by Curaport

Featuring Angelo Spinola, Shareholder, Littler Mendelson PC
Thursday, June 29
11:00 a.m. EDT 
Cost: $99 
Registration



Webinar hosts, send your announcements to: Conferences@RowanResources.com

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