Here’s Why the OASIS is So Important to Billing Reimbursement

It is important for nurses and therapists working in home health to be fully versed in the OASIS in order to be properly reimbursed for all patients. OASIS (Outcome and Assessment Information Set) is the tool Medicare uses to collect data in order to make sure that home health agencies are providing standard quality care to their patients.
It was originally used by the Institute of Medicine and is now used by The Centers for Medicare and Medicaid Services across the United States. Because Medicare is constantly adding and changing requirements as special circumstances occur, the OASIS must continue to comply and evolve as well. This can make keeping up with the adjustments challenging, but it is imperative if any agency hopes to receive fair reimbursement for their services.
Home Health & The OASIS
Between the 1980’s and 1990’s, each home health service was billed to Medicare on its own individual basis. Because of this, Medicare had no consistent way to track the care that was provided and whether or not what they were being billed was an appropriate amount. To keep everything organized and fair on all sides, Congress passed legislation that ensured better quality and a clearer view of the services being given to Medicare beneficiaries. This eventually resulted in the creation of OASIS.
OASIS Data: To comply with the rules of OASIS, data must be collected at specific times during each episode. The standard events that must be notated are admission, recertification and discharge, but other events may apply. If a patient must be hospitalized when the home health agency is providing an episode of care, data will need to be collected that notates the transfer of care to the hospital. The patient’s discharge and return home will also need to be noted, as well as the event wherein the home health agency resumes care for the patient. This data will be sent to CMS in order to provide evidence of skilled care for the patient. The data must be fully accurate and the patient’s current status included with the information in order for the agency to be reimbursed for the treatments they provided to the patient.
The OASIS Tool: The data tool is used to collect data about the patient’s status during the different episodes of care that they receive. This includes the admission, Recertification every 60 days, and the point of discharge. Every ‘Clinical, Functional, and Service’ domain special to the patient’s treatment needs to be included, along with the outcomes which should include improvement and ‘positive outcomes’. Each time that a change occurs in the patient’s form or location of treatment, a different form must be filled out to document the change in status.
Looking for Support with OASIS?
If you require assistance with your home health medical billing, it would be wise to consider outsourcing your billing. Turning to medical billing experts will help you to ensure that you are carrying out the process properly and that each treatment your agency provides is paid for. For more information on medical billing and how outsourcing can help, please don’t hesitate to reach out to us.