Posted on Thursday, July 14, 2016 2:24 PM
When it comes to fraud and improper billings, home health agencies are under tough scrutiny. Therefore, home health agencies must be aware of how to fully comply and escape the Feds’ fraud radar.
Although committing health care fraud and filing reimbursement documents improperly are different, the following practices need to be followed by each home health agency: caution, compliance, technology and teaching.
If your agency does not have the proper documents or the document requirements are unintentionally not being followed, then this can cause a huge problem for your organization.
“The main thing that agencies need to be worried about is reckless disregard,” Des Varady, CEO of non-acute health care consultant group Corridor, told HHCN. “It’s a term that means you’re not paying enough attention or doing enough to comply with the rules. It’s not fraud, but it is prosecutable.”
For agencies that are unsure if they are fully compliant with new requirements, seeking legal counsel can provide some benefit, according to Varady. While a lot of home health agencies might not have the resources to have an attorney review their processes, the investment can provide assurance.
“You ought to be talking to your attorney to make sure you’re doing everything right by the law,” Varady said. “It’s a good thing to be doing, to have someone you trust to bounce things off of. It’s tough to run a home health agency these days.”
Additionally, agencies are encouraged to utilize electronic medical records (EMRs) to improve their documentation, resulting in accurate and efficient documentation that will improve workflow.
“Documentation is a top vulnerability agencies have, which relates to getting reimbursed,” Varady said.
The CorridorComply web-based tool identifies your program from basic to advance in each of the OIG’s 7 Elements of an Effective Compliance Program. Contact a Corridor representative today to learn more about how CorridorComply can help ensure that your organization is on a strong path toward compliance excellence!
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Corridor is the nation’s preferred partner and trusted business advisor to home health and hospice providers, providing quality services and impactful results for 30 years. Focusing on key operational, regulatory and financial challenges, Corridor delivering industry-unique solutions and deep expertise in coding, clinical documentation review, compliance, billing and collections , consulting and provider staff education . At Corridor, we make the business of caring for people Better! For the most important industry updates and news that impacts home health and hospice, please make sure to sign up for our weekly newsletter to receive the latest up-to-date industry information direct to your inbox!
For additional information, please contact Corridor at 1-866-263-3795.