The Home Health Care Wire
Your source for CareVoyant and industry news. April 12, 2023
Electronic Visit Verification for Home Care Agencies - A Primer
Even though Electronic Visit Verification (EVV) has been in use for a while, the 21st Century CURES Act mandated the use of EVV for Medicaid providers. The Cures Act initially required states to implement an EVV (Electronic Visit Verification) system by January 1, 2021, for Medicaid-funded Personal Care Services (PCS) and by January 1, 2023, for Home Health Care Services (HHCS) that require in-home visit by a provider. Many states received exemptions and deferred implementation of EVV for a year or two. As of January 1, 2023, nearly 80% of the states require EVV for Personal Care Services. Quite a few states also require EVV for Home Health Care Services (Skilled).
This blog will review EVV requirements and the steps Home Care Agencies should take to implement EVV in their agencies.
The Revenue Cycle Management (RCM) process starts at intake and continues through authorization, scheduling, billing, and collections. Home Care Agencies must integrate the RCM process with operations to capture, bill, and collect revenue for all the services provided. Agencies should review the RCM process periodically and adjust the process to accommodate the changes in the patient and payer mix.
Home Care Agencies must leverage technology and software to automate repetitive and time-consuming revenue cycle tasks. Management by Exception throughout the RCM process will help home care agencies to do more with less.
This blog will discuss some critical features Home Care Software requires to manage revenue and collections to improve cash flow and the bottom line.
Through Consumer Directed Services programs, patients can hire their caregivers and manage their schedules for services authorized by Medicaid or Medicaid Waiver programs. Even though the patient can employ the caregiver and schedule the services, home care agencies will act as fiscal intermediaries by managing the payroll for caregivers and billing for the services provided.
This unique situation creates unique scheduling challenges for the agencies. Even though the agencies are responsible for billing and paying for the services, they cannot schedule caregivers like regular employees. Since the patients are scheduling the caregivers, agencies will only have exposure to the schedules or control over schedules once the time sheets are received from the caregivers.
Consumer Directed Services are authorized by Medicaid or Medicaid Waiver programs with limits on the number of hours of services provided per day, week, or month. This adds another layer of challenge to home care agencies. They must limit the services provided under authorized hours even though they have little control over the hiring of caregivers and managing their services.
When services go over authorized hours, the agencies face the uncomfortable task of telling the caregivers that they will not be paid for the services provided over approved hours.
Home Healthcare Industry News
NAHC’s Dombi: Home Health Providers Need To Embrace Medicare Advantage Opportunities
With Medicare Advantage (MA) enrollment poised to surpass traditional Medicare, home health providers will be forced to engage with plans, or otherwise, be left behind.
That’s according to William A. Dombi, the president of the National Association for Home Care & Hospice (NAHC). Dombi expressed this viewpoint during his keynote speech at the Illinois HomeCare & Hospice Council (IHHC) conference on Wednesday.
PPH Arrives Early: Measure coming to Care Compare in July
The new Potentially Preventable Hospitalizations (PPH) measure will be included in the July 2023 refresh of Care Compare, according to CMS. A previous announcement had pointed to the October refresh or "as soon as feasible."
The preview reports and star rating preview reports for the July refresh are now available in iQIES. For this refresh, the home health OASIS will be based on the standard number of quarters. Due to the COVID-19 reporting exceptions, the claims-based measures have been calculated excluding the first two quarters of 2020 data from measure calculations.
Upcoming Events
Association for Home & Hospice Care of North Carolina
Westin, Charlotte, NC - April 23-25
Missouri Alliance for Home Care Annual Conference
Margaritaville Lake Resort, Osage Beach, MO - April 26-27
New England Home Care & Hospice Conference & Trade Show
DoubleTree, Manchester, NH - May 2-4
ABOUT CAREVOYANT
CareVoyant is a leading provider of cloud-based integrated enterprise-scale home health care software that can support all home-based services under ONE Software, ONE Patient, and ONE Employee, making it a Single System of Record. We support all home based services, including Home Care, Private Duty Nursing, Private Duty Non-Medical, Home and Community Based Services (HCBS), Home Health, Pediatric Home Care, and Outpatient Therapy at Home.
CareVoyant functions – Intake, Authorization Management, Scheduling, Clinical with Mobile options, eMAR/eTAR, Electronic Visit Verification (EVV), Billing/AR, Secure Messaging, Notification, Reporting, and Dashboards – streamline workflow, meet regulatory requirements, improve quality of care, optimize reimbursement, improve operational efficiency and agency bottom line.
For more information, please visit CareVoyant.com or call us at 1-888-463-6797.