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Home Health Coding and OASIS Reviews

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SMART Accuracy rate is 98% versus 90% Compliance

If an organization filed 500 claims each month and submit incorrect coding or OASIS data, it impacts the agency financially, incorrect Outcomes and Medical Review risk. (Eligibility, Compliance and Condition of Payment)

·  98% Accuracy Rate (2% Error Rate) = 10 incorrectly billed claims

·  90% Accuracy Rate (10% Error Rate) = 50 incorrectly billed claims

 Accurate billed claims= $2038.22 estimated revenue per claim for a quality compliant agency

Consider how the compliance of your current coding and OASIS reviews can impact your organization. 

What results from these billing errors?

·  Incomplete or unsupported diagnosis coding

·  Reimbursement adjustments (either bill more or less than compliant)

·  Full claim denial

·  Untimely payment

·  Compliance triggers and increased oversight

UNPAID REVENUE

What else can SMART do for your Programs?

Check out our website

OASIS Compliance Review

• Medical Necessity

• Face-to-Face Compliance

• Reasonable and Necessary

• Homebound eligibility

• OASIS paints the clinical picture

• Narrative summarizes the skill and education provided

• Provider Verbal Authorization confirms continued care and visit frequency

QAPI - Quality Assessment and Performance Improvement

• Audits - completed monthly and with data roll up quarterly

• QAPI meeting w/minutes, quality reports and risk management (PAEs & Incidents) for survey readiness

• PIP development and education

• Agency Clinician Education  

• Leadership training of CMS expectations and recommended best practices

With SMART HCR’s partnership, we can help you and your programs reach successful practices.

Our Coding/OASIS/QAPI experts are -

• United States-Based

• Staffed Entirely by Registered Nurses

• Clinically Experienced for Real World Reasonability

• Offering a COMPLIMENTARY Consult and Review to Start