Facebook Live Presentation - Q&A About NOA’s

A Team of panelists from Precision Medical Billing (PMB) answered specific questions presented in the PDGM Facebook Group about NOA’s.  In addition, the PMB experts provided helpful tips about NOAs throughout the live presentation. Panelists: Petria McKelvey—CEO, Precision Medical Billing Sue Brooks—Director of Billing and Client Services, Precision Medical Billing Rosie Baker—Revenue Recovery Supervisor, Precision […]

Prepare Now For the Home Health Value Based Purchasing Model

Article Highlights CMS introduced the Home Health Value Based Purchasing Model (HHVBP) in nine U.S. states in 2016. CMS is planning to roll out the HHVBP program across the entire country in 2022. Home health agencies (HHAs) not currently under the HHVBP program should prepare now to maximize revenue collections. *** The Centers for Medicare […]

We Help Home Health Agencies With Review Choice Demonstration (RCD)

Article Highlights Every year, there is considerable home health care fraud in the U.S. CMS has rolled out a Home Health (HH) Review Choice Demonstration (RCD) program to help prevent fraud. PMB can support your efforts to satisfy the Medicare prior authorization requirements through pre-claim review (PCR) so that you can receive payment for services. […]

We Can Serve As Your Home Health Intake Coordinator

Article Highlights Home health patients are trending toward using insurance, not traditional Medicare. Intake and insurance verification is critical when working with third party payers. Let PMB serve as your home health intake coordinator to receive payment for services. *** Home health agencies have a lot to consider before ever providing services to patients. Because […]

Consider Our Home Health Eligibility & Prior Authorization Solution

Article Highlights Home health agencies are dealing more and more with private insurance companies, not just Medicare. Working with private insurance companies comes with a unique set of eligibility and prior authorization requirements. Work with PMB to alleviate administrative burden managing the Medicare and private insurance payer mix. *** Home health agencies are accustomed to […]

Select PMB As Your Billing Agency When Applying To Be Medicare Certified

Article Highlights Medicare is very concerned about fraud in home health care claims. Indicating a billing agency on your CMS-855A application shows that you take this seriously. Understand the role of accrediting agencies on the path to being Medicare certified. *** Becoming a Medicare-certified home health agency is a challenging, time-consuming process. CMS, which administers […]

We Provide Emergency or Virtual Home Health Billing For Your Agency

Article Highlights Employee turnover can negatively impact home health billing. We provide emergency billing support or virtual billing support in a pinch. We can step in as a medical billing manager to optimize revenue collection. Consider providing education and training to your office staff on home health billing. *** Home health agencies often run into […]

3 Ways to Be Successful With Telemedicine Medicare Billing

Article Highlights Telemedicine usage is on the rise among seniors. You need processes to support complex telemedicine Medicare billing. Consider outsourcing Medicare telemedicine billing to PMB. *** Medical practitioners may think that telehealth services are only on the rise among younger patients that are accustomed to using technology for everyday life. However, telehealth services are […]

Solving the Need for Telemedicine Billing Solutions During COVID-19

Before the global pandemic, who could have imagined a world where medicine shifted paradigms virtually overnight. While government officials and health leaders urged patients to stay at home, medical professionals struggled to continue providing quality care to their dedicated patients. It certainly expedited the timeline to expand medical practice adoptIon of telehealth services. Prior to […]

6 Financial Planning Best Practices for Home Health Agencies

When it comes to your finances, every element of your agency plays a significant role. How you work with your clients, train your staff, and implement focused business practices will determine how smoothly everything runs. On top of that, you need to be realistic about your company and how well you are doing financially on […]

UPDATED: Emergency and Disaster Instructions

When a natural disaster, extreme weather or emergency occurs that affects providers and the Medicare beneficiaries that they serve, special emergency-related policies and procedures may be implemented. For detailed information on these policies and procedures, please see the following resources: For information when an applicable 1135 waiver   (PDF, 346 KB) has been granted For information on […]

Lawmakers Introduce New Bill Paving the Way for Home Health Telehealth Reimbursement

Home health providers are one step closer to getting the No. 1 thing they’ve been asking for since the COVID-19 pandemic began: reimbursement for telehealth-driven visits. On Friday, U.S. Senators Susan Collins (R-Maine) and Ben Cardin (D-Md.) introduced the Home Health Emergency Access to Telehealth (HEAT) Act, a bipartisan bill to provide Medicare reimbursement for […]

CMS Announces New Repayment Terms for Medicare Loans made to Providers during COVID-19

The Centers for Medicare & Medicaid Services (CMS) announced amended terms for payments issued under the Accelerated and Advance Payment (AAP) Program as required by recent action by President Trump and Congress.  This Medicare loan program allows CMS to make advance payments to providers and are typically used in emergency situations.  Under the Continuing Appropriations […]

Action needed: Register for an iQIES Account

The Quality Improvement and Evaluation System (QIES), which providers and vendors use to submit assessment data, is being upgraded to make the system more reliable, scalable, secure, and accessible.  The enhancements will occur in phases (by provider type) and began with Long- Term Care Hospitals (LTCHs) in March 2019, followed by Inpatient Rehabilitation Facilities (IRFs) […]

Congress Debates Bill to Automate Prior Authorization in Medicare Advantage Plans

Recently the House of Representatives’ Small Business Committee convened for a hearing on utilization management and barriers to care in small medical practices. In particular this hearing focused on the application of prior authorization within Medicare Advantage (MA) plans and the associated challenges faced by patients and providers of services due to prior authorization requirements. […]

Home Care Agencies Often Wrongly Deny Medicare Help To The Chronically Ill

Colin Campbell needs help dressing, bathing and moving between his bed and his wheelchair. He has a feeding tube because his partially paralyzed tongue makes swallowing “almost impossible,” he said. Campbell, 58, spends $4,000 a month on home health care services so he can continue to live in his home just outside Los Angeles. Eight […]

Increased Enforcement Against Home Health Agencies

With the recent rise in medical services provided outside of a doctor’s office, there has been a surge of FCA enforcement actions against home health agencies (HHAs). HHAs are public or private agencies or organizations that are primarily engaged in providing skilled nursing services and other therapeutic services to patients in their residence.[1] The last […]

Medicare decides a cost-saving strategy costs too much

After pushing more medical care out of hospitals and into patients’ homes, the federal government wants to pay less for home health care. Impending changes in Medicare’s home health payment system would dramatically alter how agencies are reimbursed for services, cutting payments by 8 percent. Lower rates would squeeze profit margins in what has been […]

Medicare Sequester Extended Two Years

The Bipartisan Budget Act of 2019, signed into law last week by President Donald J. Trump, includes an extension of the Medicare sequestration cuts for an additional two years. This across the board cut of two percent applies to all Medicare provider payments. The Bipartisan Budget Act of 2019 will increase federal spending by $320 […]