Face to Face (F2F) documentation has been an exceptional burden for home health agencies (HHAs) ever since its inception. With constant changes in interpretation and documentation expectations, the denial rate based on inadequate or insufficient F2F documentation continues to average 59% of claims reviewed. Further, increased focus on documentation of home health certification and re-certifications in the last few years has added to the burden of denials for home health agencies.
That is especially true when home health agencies are confronted with Additional Documentation Requests (ADRs) related to Phase 2 of Probe and Educate or any medical review request. Under the Probe and Educate program mandate, there is no limit to the length of time an HHA can be subject to these reviews if greater than one denial is received in the claim sample. HHAs must be prepared to proactively avoid claim denials through effective, compliant documentation.
In this informative session, Judy Adams will assist HHAs in avoiding denials and receiving the reimbursement they are due for their claims.
Everyone involved in home health must be knowledgeable about the Probe and Educate and Pre-Claim Demonstration Projects and work together to ensure home health documentation is meeting the requirements so claims are paid on first submission. Survival of the health agency is dependent on submitting compliant claims and documentation to support the provision of documentation that supports both eligibility and coverage criteria.
Who should attend?
Home health staff with administrative, supervisory, quality improvement and compliance responsibilities plus clinical visiting staff and billing staff.
- Apryl Swafford
Judy Adams, RN, BSN, HCS-D, HCS-O, has been involved in health care in numerous health care setting over the span of her career. She has been involved in nearly every aspect of home health care over the last three decades including direct clinical care, supervision, administration and quality improvement.