Coding for home health is extremely complex. It not only affects a home health agency’s reimbursements, but also the ratings, referrals and overall brand. How can an agency know if they are leaving money on the table?
When it comes to OASIS, CMS wants to see improvement. Scoring an OASIS correctly is crucial to ensure proper payment and outcomes. Outcomes and star ratings go hand in hand because the OASIS items that are considered 5 Star items also impact the agency’s overall ratings.
Every patient must have a specific plan of care. The interventions and goals must be specific to the patient. And the primary diagnosis or primary focus of care should always be on the plan of care.
Analytics are also essential to helping agencies improve their documentation and provide education.
Whether an agency is looking to outsource or they are coding and reviewing in-house, there are three things Jessica says to look for when considering OASIS documentation:
1. Is the clinician’s OASIS a true reflection of the care the patient needs and is receiving?
2. Is the agency potentially leaving more on the table and do they know?
3. What impact are they having on outcomes and star ratings?
When a patient is looking for care, they are depending on the ratings of an agency as an indication of whether they will also receive quality care. Documentation affects reimbursement, ratings, and ultimately the brand of the home health agency.