Study: Improper Payment Errors Amount to $9.4B in Home Health

Home health billing and compliance errors happen all of the time. These issues cannot be ignored or your agency will end up with a large amount of fines and denials, not to mention the outstanding money that is owed to them for services that were already performed.
About 9.4 billion dollars was lost to improperly submitted home health claims in 2014, and each year the results seem to increase. There are so many ways that you can avoid this money loss, and we want to help you learn them so you don’t fall into the same ruts that so many other home health providers have.

How To Avoid Errors

There are several tactics that will prove to be good rules of thumb when it comes to ensuring that your claims are being submitted accurately. Some examples of these are:

  • Make sure that your team is well-informed about the up-to-date coding rules and regulations. Current information can be accessed on the CMS Home Health Agency Center pages.
  • Stay tuned with newsletters and conferences that will inform you of any new rules or regulations that have been set, including new HCPCS and ICD-10 codes or any other procedural terminology your team should be made aware of.
  • Take a close look at the patterns that are existing in your billing issues. Are there consistent reasons why your claims are being rejected? What corrective action can be taken to avoid improper claims?
  • Keep reports of the weekly billing, episodic billing, per visit billing, private pay, accounts receivable, rejections, ADRs and denials to keep a clear insight into your current status of financial health.
  • Ensure that your entire staff is onboard with the roles they play and the steps they must take to gather the information necessary to file a proper claim.
  • All payments should be posted to the correct claims as soon as possible, preferably the day following the receipt of payment. Your team needs to stay on top of each claim and processing it on a timely basis will ensure that no disruptions will take place.
  • Consider using the help of a home health billing company to streamline daily billing operations and feel confident that you are relying on a team that fully understands the process of filing the necessary claims and following up on their progress.

Outsourcing Your Billing

It’s understandable to be hesitant about getting more people involved in the financial systems of your company, but when it comes to your revenue cycle, you need to know that your money is being taken care of properly.
If you are considering outsourcing your billing, there is simply no better way to avoid claim errors. Using these services will give your agency speed and increase your accuracy while lowering the time it takes for the arrival of reimbursement. It is not unusual for an agency such as yours to encounter home health payment errors. If you would like to explore the option of improving your medical billing process, please do not hesitate to contact us here.