Featured question from Biller’s Talk

Source: The Biller’s Association for Long-Term Care, which includes access to Biller’s Talk, a great peer resource for long-term billers and other involved in the revenue cycle process.
Q: A patient came in from the hospital. The patient was admitted to Medicare Part A and was expected to stay, however after two hours, she wanted to go home and the physician ordered home health services. The patient didn’t sign the contract at the time of admission …

Calculating Reimbursement Under PDPM

The new Patient Driven Payment Model (PDPM) goes into effect October 1st, 2019. While staff will continue to rely on computer software to convert MDS assessment data to calculate reimbursement rates, it will be vital to fully understand the rate calculation methodology to properly identify opportunities to maximize reimbursement and accurately project revenue.
In this FREE special report, our industry experts are providing the inside scoop on how you can prepare for these significant changes. We’re …

LUPAs remain a complicated area under PDGM

Source: Home Health Line
Despite the fact that payment episodes under the Patient-Driven Groupings Model (PDGM) will last 30 days instead of 60, LUPAs still will occur under the new payment model CMS is creating beginning on or after Jan. 1, 2020.
Unlike with the PPS, where a LUPA involves four or fewer visits during an episode, the threshold for the number of visits needed for an episode to be a LUPA under PDGM will vary.
Thresholds will …

CMS schedules Q&A session related to guidance from OASIS-D events

Source: Home Health Line
CMS has announced that from 2 p.m. to 3 p.m. EST Nov. 29, it will hold a question-and-answer session related to guidance on the OASIS-D presented during webinars in August and September and a Train-the-Trainer event in Baltimore in November.
OASIS-D takes effect Jan. 1, 2019.
Learn more about the event at https://go.cms.gov/2eA0xZn.