Hospice Comprehensive Review

Developed to provide the Client with a comprehensive review of HHPPS requirements to improve billing accuracy, strengthen regulatory compliance, and assist in cost containment efforts. HMI will assist the agency to ensure that all charges are captured appropriately, reimbursement is optimal for the services provided, and a schedule exists for filing OASIS assessments and claims in a timely manner.

The scope of the engagement includes on-site review of home health records. The records and corresponding claims are reviewed for: 

• Eligibility criteria for home health enrollment 
• Accuracy and completeness of documentation of services provided 
• Timing of assessments 
• Appropriateness of HIPPS code assignment 
• Accuracy and completeness of Plan of Care (POC), certification, and recertification forms 
• Reporting LUPA, PEP and SCIC adjustments 
• Consolidated vs. excluded billing 
• How and when to bill Medicare Part B 
• Outcomes management

Value Added Benefits for this Service: 

• More knowledgeable staff 
• Quantifiable results

Added Feature: 

• Coding and Billing Helpline provided at no additional cost during the term of the contract. Client's staff may take advantage of this helpful service to answer questions arising from coding and billing issues.