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Compliance checklist for home health


Screen capture of part of a page from the Checklist.

Looking for a complete list of documentation needed for PDGM and RCD?

Home care providers have less time than ever before to collect all the right documentation for claim submission under Medicare's new 30-day billing periods and the Patient-Driven Grouping Model (PDGM.)

And for providers in Ohio, Illinois, Florida, Texas and North Carolina, the five states targeted by the Centers for Medicare and Medicaid (CMS) for a Review Choice Demonstration (RCD), speedy procurement of all necessary documentation is even more important. Most home health agencies in RCD states are opting for pre-claim reviews, meaning they must submit all information for review prior to filing the claim for Medicare reimbursement. "Timeliness is on everyone's mind right now," said J'non Griffin, owner of Home Health Solutions. "Agencies are up against the clock to get everything signed and returned in an expedited manner." In the rush to get paperwork in order and meet new PDGM and RCD deadlines, home care providers need to be especially cautious not to overlook any of the compliance requirements, J'non said. Here are two ways Home Health Solutions can help. Complete Compliance Checklist "The Paper Trail: A Complete Compliance Checklist" is a 12-page digital guide sold by Home Health Solutions on its web site store. Instead of a lengthy guide which can take some time to read, compliance information is presented in a quick-read format as a checklist. Each necessary item is listed, and simple questions are used to walk the reader through all the necessary documentation needed.


As an example, in the Face-to-Face Encounter section, the Guide asks whether the patient is coming to home health from a facility or a community physician, and lists what type of paperwork is necessary for each. Tips on the side provide additional detail. (See illustration above.) This product does not take the place of your documentation, but it tells you exactly what you will need to provide for compliance. It is based on information provided from the Medicare Administrative Contractors and it is a great resource to copy and provide to your staff for use in collecting necessary information prior to claims submission. The Complete Compliance Checklist is available as an instant download in PDF format for $24.99.


12 PDGM Timesavers

An additional product in the HHS online store may also be helpful in meeting new 30-day timeframes for PDGM and pre-claim submission requirements. We've collected 12 examples of common misconceptions about the need for physician orders -- and explained how other documentation will suffice instead. If your agency is spending time chasing down signatures on multiple physician orders for every patient, you need to take a look at these helpful timesavers. We've paired the digital list with a complimentary link to view our recent 60-minute webinar on "Orders Management Under PDGM." Get webinar and the list of 12 Timesavers for just $34.99.