Home Health agencies have dealt with the ongoing level of scrutiny on documentation or many years. Leadership are relieved when no external home health care audits have been implemented for their agency over the past few years and cringe at the thought of someone asking for charts. Others believe that no news is good news and not being selected means that everything must be OK.
With ever shrinking reimbursement, it is not enough to have a positive revenue stream. Agencies MUST protect that revenue against denial risk that has sometimes struck 3 years after the care was provided.
Documentation expectations are not the favorite topic for many clinicians and those who work to improve the situation may feel like it is falling on deaf ears. K&K Health Care Solutions provides specific home health care audits and analysis with detailed follow up plans and tools to ensure accountability that have been proven to decrease risk and protect the revenue agencies have worked hard to secure.
IN DEPTH HOME HEALTH CARE AUDITS -
WHAT IS REVIEWED?
Cost can vary based on your agency size and needs. We have package discounts available as well as pricing for standard audits and/or reviewing your current reviewer. See products below or contact us to discuss a customized package for your agency.
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With ever shrinking reimbursement, it is not enough to have a positive revenue stream. Agencies MUST protect that revenue against denial risk that has sometimes struck 3 years after the care was provided.
Documentation expectations are not the favorite topic for many clinicians and those who work to improve the situation may feel like it is falling on deaf ears. K&K Health Care Solutions provides specific home health care audits and analysis with detailed follow up plans and tools to ensure accountability that have been proven to decrease risk and protect the revenue agencies have worked hard to secure.
IN DEPTH HOME HEALTH CARE AUDITS -
WHAT IS REVIEWED?
- Recently discharged patients who received any combination of nursing, physical and/or occupational and/or speech therapy over the course of an episode of care. If there is a recertification involved, the initial episode will be the focus of the review and additional episodes will be evaluated to determine if continued care is supported.
- The sample for the home health care audit should represent a sample that received a cross section services in some capacity with total visit numbers throughout the range of practice patterns. If physical therapy, occupational or speech therapy complete admissions, several of those cases should be included.
- The Start of Care OASIS is part of the review, regardless of the discipline that completed the form, from the perspective of supporting the inclusion of therapy in the episode and consistency of responses between the admission and the therapy evaluation(s).
- The Plan of Care / 485, all visit notes, all orders related to services (including the F2F) and any communication notes will be reviewed to determine if there is sufficient information to support the visits provided.
- If the agency is paper based, copies of all documents mentioned above should be gathered and shipped on a mutually agreed upon date.
- If the agency is on an electronic system and has the ability to grant access, the documents can be reviewed electronically and no paper copies are needed.
- Faxing of documents is not recommended due to the size of some of the documents.
- Each episode reviewed will result in a detailed audit tool pointing out strengths and weaknesses found in the documentation with specific examples provided.
- The trends seen from the sample are pulled into a written report that explains the concerns, examines the financial implications of a denial and provides strategies to improve the documentation based on the findings.
- A one hour conference call will be scheduled after the agency receives the report for individualized consultation on findings and next steps. This allows any remaining questions to be addressed directly. Staff that review records are strongly encouraged to attend in order to assist with follow through.
- The audit tool used is given to the agency for use on an ongoing basis if that is desired.
- The average financial risk per episode in the hundreds of documents already completed is just over $1000. That means the 20 record sample is reflecting a $20,000 risk – so think about how many patients are receiving care from the agency at any given time. Being proactive in decreasing risk can pay for itself very quickly and keep agencies focused on the necessary components of defensible documentation.
Cost can vary based on your agency size and needs. We have package discounts available as well as pricing for standard audits and/or reviewing your current reviewer. See products below or contact us to discuss a customized package for your agency.
Subscribe to our YouTube Channel for Free Education