CMS sets Sept. 30 start date for RCD in Ohio; no dates yet for Florida, Texas, North Carolina
Home care providers in Ohio are assimilating this week's announcement by the Centers for Medicare and Medicaid Services (CMS) that the Review Choice demonstration will roll out to their state Sept. 30.
Providers in Ohio will begin the selection process on Aug. 16, deciding whether they prefer pre-claim reviews or post-payment reviews. They may also opt out of the Review Choice demonstration, but agencies which do not participate will see an automatic 25 percent reimbursement penalty and will still be subject to some post-payment reviews. Agencies which have not yet made a selection by the end of the process on Sept. 15 will be enrolled by default in the post-payment review process.
No dates were announced for the launch of Review Choice in Florida, Texas or North Carolina, the remaining three states targeted by CMS for the Review Choice demonstration. Documentation is the key Although CMS will not require any new paperwork for pre-claim submission, the demonstration does require specific documentation in place to establish homebound eligibility and medical necessity, and evidence must be provided that the face-to-face encounter between physician and patient met all requirements. “Review Choice is all about having all the necessary documentation in order,” said J'non Griffin, Owner of Home Health Solutions. "To successfully navigate Review Choice, agencies are going to have to have all the crucial face-to-face documentation in order, from dates and signatures to clinical encounter notes. They're not going to be able to overlook the therapy eval or important pieces." She recommends agencies in Ohio shore up documentation with either in-house review processes to find and correct errors or contract for outsourced services provided by a trusted partner with a proven track record.
(To read about the helpful services offered by Home Health Solutions, click here.) We can help
We've put together a helpful guide especially for agencies in Ohio and other affected states. The Review Choice 101 Digital Guide from Home Health Solutions includes 101 documentation tips and strategies to pass reviewer scrutiny – all presented in checklist form to save time for busy home health professionals.