Clarification of 13th and 19th Home Care Regs and HomeRun Process

Tweet

 

Hi Everyone,

Happy Holidays!

We wanted to give you all a clarification of the process related to what you should do if the 13^th or 19^th Therapy re-evaluation/reassessment does not happen.

Before we provide this process, we wanted to give special thanks to the following people for helping is wade through this somewhat counter intuitive process:

Tim Sundberg, Empathy Care

Mary Tyler, Backus Home Health

Cheryl Leslie, HMS Healthcare Management Solutions

Mary St Pierre, NAHC

Here are the Steps.  Let’s say for the sake of argument that the re-eval/reassessment does not actually happen until the 16^th actual visit.  Here are the HomeRun Steps:

1)      The 13^th visit is to remain billable as a routine visit.

2)      The 14^th, 15^th and 16^th visits are to be marked non-billable as “Medicare Non-Covered Charges”.

3)      The 16^th visit is to be given the activity code of “THERAPY EVAL/ RE-EVAL” even though it is marked not billable!

4)      The 17^th visit becomes the de facto 14^th visit and it moves on from there.

As a result of these clarifications we will be making some adjustments to the Therapy Alert report as well as VDR164 “the 13^th and 19^th therapy visit warnings”.  Until we do please either turn off this edit or use the override function.

Thanks Everyone!