Home health care billing is a complicated task. Are you sure that you are receiving all the payment you have earned? The How-to Guide to Home Health Billing is your comprehensive guide to implementing accurate, compliant, and competent billing practices at your agency. This book will help you to provide the best training possible to your billing staff and those who impact billing. You'll increase competence and confidence about billing requirements and practices.
This book will help you:
- Provide effective training for all billing staff, whether new to billing, or new to the home care system; along with tips for other agency staff such as therapists and nurses, who impact the billing process, on collaborating to ensure billing accuracy.
- Focus on red flag areas and understand the complicated relationship between billing and coding/OASIS assessments.
- The guide will give you the practical 'nuts and bolts' education and information you need by taking difficult concepts and explaining them in an easy to understand way.
- This step-by-step guide to billing not only covers Medicare, but also Medicaid and commercial insurance billing.
Table of Contents:
Home Health Billing Overview
Types of Insurances
Medicare part A and B
PPS - Medicare Bundled Services
Providing services in Medical Day Care
Home Health Benefit
Eligibility Requirements
Need to know for accurate verification
Billing Requirements
Pre-billing check list
Medicare Secondary
Clinical Documentation Requirements for Billing
How clinical and billing interact
Face to Face Requirement
Verbal order RAP
OASIS Data Submission
Tracking of 485
Diagnosis Coding & the Billing Process
What billing needs to know about coding
Validity, appropriateness, completeness of codes
Claim submission
UB04 claim form
837I electronic claim
Mastering the FISS System
Direct Data Entry
Claim adjustments
RTP Location
Roster Billing
Reports
Collection follow up
Common claim Denials
Claim Appeals
Credit Balance Report
Working the Remittance Advise
EFT
PC Print
Medical Review ADR/CERT/RAC/ZPIC
Compliance
False Claims Act
Levels of Appeals
Tools and Resources