American seniors are enrolling in Medicare Advantage (MA) plans at a furious pace. In fact, it’s projected that 80 – 90% of Medicare participants will be enrolled in an MA plan by 2030. But these plans are all different, making it difficult for agencies to effectively code and bill for maximum reimbursement. It’s also a challenge for agency staff to keep up with the nuances and changes of the various plans ..read more

The CAHPS hospice survey mandated by CMS is vital to your agency’s success. The survey determines your Star rating, which is publicly posted on Medicare’s Care Compare website so that families and referral sources looking for hospice care can make an informed choice. To keep your agency competitive, it’s important to have a clear understanding of the do’s and don’ts of the survey process, as well as some tips for improving your agency’s scores ..read more

Kristi Gowan-Fisher, RN, HCS-D, COS-C, HCS-O, HCS-H, has healthcare in her genes. “I remember following my mom in and out of home health locations when I was young,” she said. “I always knew I wanted to go to nursing school so I could work helping people in some way.” Find out how her deep understanding of coding, nursing and home health helps HEALTHCAREfirst customers solve their coding challenges ..read more

In home health and hospice, most billing errors occur during the intake process, when entering incorrect patient or payor information, adding invalid diagnosis codes or authorization, or ordering services not covered by the payor. In this blog, we explore three common billing errors and how to avoid them ..read more

While Medicaid Advantage plans are skyrocketing in patient utilization, many home health and hospice agencies lack the in-depth know-how to accurately bill for them. This knowledge gap in billing requirements can stall growth. In this blog, we explore how outsourcing revenue cycle management (RCM) can change that ..read more

Ronda Howard, VP, Revenue Cycle and CAHPS, HEALTHCAREfirst Formerly: Patient Access Director From bedside nurses and operational leaders to OASIS, billing and coding experts, the team at HEALTHCAREfirst has been in your shoes, working in many of the roles within home health and hospice agencies. Ronda Howard is one of them. Q ..read more

To gauge the effectiveness of revenue cycle management (RCM), hospices need to manage five key performance indicators (KPIs). These KPIs are linked to cash collection, including measurements of the speed and accuracy of payments, as well as any issues that could lead to claims denials. That’s why monitoring these KPIs helps hospices avoid the most common RCM pitfalls ..read more

A Medicare Advantage plan, also known as a managed care plan, is a Medicare-approved plan from a private insurance company that offers an alternative to original Medicare for your health and drug coverage — and these alternative plans are on the rise. According to CMS, 50%, or 31 million, of all Medicare beneficiaries are enrolled in a Medicare Advantage plan. In fact, by 2030, Medicare Advantage plans are expected to enroll 60% of Medicare beneficiaries ..read more

Completing the OASIS review can be time consuming, which can impact the bottom line for many agencies. This cheat sheet provides detailed information to help providers fill out complex, but critical sections — C0100 through C0500.  ..read more

By: Liz Silva, Product Manager & Senior Business Analyst, HEALTHCAREfirst According to new CMS guidelines, Home Health CAHPS (HHCAHPS) results will factor into 30% of the overall Medicare reimbursement you receive. This means that HHCAHPS survey responses, and how you address the issues and pain points identified in survey results, are a major factor ..read more