Noncompliance With Medication ICD-10 in Home Health
Your patient is taking less medication than prescribed, but the visit note only says “patient is noncompliant.” Your coder now has to determine what the documentation supports before assigning the ICD-10 code. For your agency, that missing information can mean more coding queries, claim rework and compliance risk. Key Takeaways Identify who was noncompliant, what […]
7 Challenges in Home Healthcare Staffing (And Why Hiring Harder Isn’t the Fix)
63.3% of home health providers turned down referrals last year, according to Home Health Care News. If you have a home health agency, hiring more nurses and other healthcare professionals can’t fix the staffing shortage caused by hours lost to documentation, scheduling and coordination instead of patient care. Key Takeaways Measure where clinical hours go […]
What Is PDGM for Home Health Agencies?
The diagnosis and assessment decisions your team makes before care begins determine how a 30-day period is classified and paid under the Patient-Driven Groupings Model (PDGM). PDGM codes aren’t a separate code set. You need to know which inputs control grouping, who owns each input and where an error changes your home health payment. Key […]
TPE Audit Guide: How Home Health Providers Cut Claim Denials Through the Audit Process
Is your agency ready for a Medicare Targeted Probe and Educate (TPE) audit? A TPE audit reviews 20 to 40 claims per round to determine whether your documentation supports the care you billed. Preparing early can help reduce claim denials, protect cash flow and limit the staff time needed to respond to documentation requests. Key […]
Revenue Cycle Management Best Practices That Improve Cash Flow in Home Health Agencies
Your revenue cycle performance depends on how consistently you execute every stage of care. Layered QA, clear ownership and defined workflow controls reduce delays in your payment. Key Takeaways A claim can’t move forward when referral details, authorizations or physician orders are incomplete. Preventive QA, concurrent QA and pre-bill QA each stop different problems before […]
How to Improve Patient Outcomes Through OASIS Documentation in Home Health Agencies
Every OASIS assessment should inform how you care for the patient. When OASIS documentation reflects the patient’s condition and guides the care plan, your home health agency can provide better patient care and accurate reimbursement. Key Takeaways Accurate OASIS documentation gives every discipline the same clinical baseline. All significant assessment findings should appear in the […]
How Can LUPA in Home Healthcare Be Avoided?
One missed visit, a delayed note or an unresolved cancellation can leave a patient below the assigned LUPA threshold and change a full payment period to per-visit reimbursement. Preventing LUPA in home health depends on how your agency manages the process from intake through billing. Key Takeaways Many preventable LUPA cases happen because intake, clinical, […]
What Does It Mean to Be OASIS Certified? A Guide for Home Health Agencies
CMS relies on OASIS data for home health quality reporting. OASIS certification shows that a clinician knows the assessment rules, but only ongoing review, training and clinical oversight confirm that those rules are applied consistently. Key Takeaways Certification works best when agencies reinforce it through ongoing QA, training and clinical oversight. QA review verifies that […]
The Most Common Healthcare Revenue Cycle Management Bottlenecks in Home Health
According to a 2024 CMS report, insufficient documentation contributes to up to 51.4% of home health claim denials. Many of these issues begin with the OASIS assessment and plan of care, long before coding or QA reviews the chart. Timely completion and submission of these documents are key indicators of revenue cycle performance. Consistent staff […]
The Hidden QA Layer Missing From Most Medical Billing and Coding Teams
MDaudit’s 2025 provider data found that outpatient coding-related denials rose 26% in 2025, from errors in diagnosis coding, modifier usage and incomplete documentation. Home health agencies see these same three issues affect their denials, delayed payments and lost staff hours. Key Takeaways Complete documentation reduces coding errors before they affect the billing process. A structured […]