Home Care Agency Compliance: Is your Agency at Risk?

 

The Current Environment

 

Mandatory compliance programs, ever-changing regulations and heighted scrutiny requires Home Care executives to proactively focus on the OIG’s seven pillars of compliance — and the priority elements of documentation, coding, billing and reimbursement for the Agency. The OIG believes compliance risks exist in delivering medically unnecessary services, insufficient OASIS and visit documentation, inadequate supervision, billing for services not actually rendered, and duplicate billing.

 

How We Can Help You Succeed

 

Our experience proves that periodic reviews of compliance program elements result in the most effective programs. Effective compliance programs eliminate, reduce or mitigate an organization’s risk, and build awareness of compliance efforts, and ensure income is captured, billed and kept. KHC and Client personnel work together as a team to plan and perform the compliance programs reviews, resulting in an effort that is cooperative, as well as efficient. Risk exposure is assessed based on known areas of potential fraud and payment risk trending in the Home Care industry.

 

Our Home Care review can be customized to your specific needs including:

• Review of the OIG’s seven elements of an effective compliance program to identify and prioritize compliance and non-compliance risk. 
• Provide targeted medical record and process reviews to focus exclusively on
  HOME CARE HOTSPOTS:

Home Health Certification/ Plan of Care/ CMS485 Referrals/ Authorizations Validity of Physician Order and Homebound Status Oasis Content and Reporting Face-To-Face Documentation Visit Cycles/ Frequency/ Duration/ Lupas Skilled Care Assessment

Therapy Assessment / Reassessment On-Going Clinical Progress Documentation To Support Service Supervision of Care Delivered By Aides Billing and Coding Review ICD-10 Transition: Training/ Implementation

• Improve and develop internal compliance controls and standards.
• Create and implement necessary policies and procedures for the Home Care Agency’s compliance program.
• Provide assistance in the development and implementation of the Agency’s operational action plan for improvement.

 

 

KOHLER HealthCare Consulting, Inc. (KHC)

has an extensive history in providing assistance to the Home Care providers in understanding the rapidly changing regulatory environment by developing effective and regulatory responsive policies and procedures, and performing compliance reviews to assist entities in adhering to established guidelines.

 

KHC's exposure to and expertise in a variety of healthcare entities gives us a unique perspective in addressing the myriad of compliance challenges that exist today and enables us to analyze and apply program elements that are both operationally feasible and compliant with Federal and State regulations.

 

Our Clients look to us for practical, comprehensive recommendations and useful tools that can be implemented and maintained by the Home Care Agency. We consider your culture in our approach and design while meeting the required standards.

 

How do we do this? By providing a highly skilled, multi-disciplinary team that includes nurses, clinical care providers, rehabilitation administrators, compliance, coding, billing, finance professionals and regulatory issues. Let us help you put the pieces together.

 

 

Contact us to help

put the pieces together

Charlotte Kohler (410) 461 − 5116

Daria Malan (410) 598 − 1221