Home health agencies rely on highly trained staff to keep operations rolling and to serve clients with quality care equaling a high retention rate and a healthy cash flow. However, cash flow depends on more than just a source—it requires a skilled home health coder to keep it streaming instead of getting bottle-necked (delayed) or vaporized (denied).
Need for a Quality Home Health Coder
Many organizations rely on clinicians doubling as coders or settle for an entry-level coder who, for all their determination and good will, simply suffer from a daunting learning curve. These agencies limp along suffering the consequences of lost productivity, poor reimbursement and and non-optimal cash flow without a top-tier home health coder.
Some homecare organizations take the need for an experienced coder seriously. The new recruit has coded for hospitals, outpatient care, or doctor’s offices but is not certified for home health or hospice. The truth is, most coding “rules” for receiving maximum reimbursements in homecare are different from other providers. These variances include required documentation, knowledge of the OASIS and understanding of home health billing requirements. There is no substitute for a home health certified, fully trained and experienced coder.
There are those agencies who have indeed obtained a certified home health coder and have invested in extensive ICD-10 training. Then watching in horror, their “star coder” suddenly walks out the door. Veteran coders are hard to find and can’t always be replaced fast enough to prevent chaos from erupting at your agency.
Never Settle for Less Than a Home Health Coder
Hiring an inexperienced, non-certified home health coder, or relying on clinicians to code might, perhaps, save some money upfront, but will cost you more in the long term. It’s simply a bad idea leading to at least these 5 negative consequences:
- Codes entered incorrectly or incompletely result in payment delays or rejections until time-consuming corrections are made.
- Cash flow back-up caused by poor productivity due to lack of knowledge or inexperience.
- Codes submitted aren’t supported by OASIS and care plan documentation triggering poor case-mix weights and less than optimal compensation for services.
- Coders are unsure of clinical documentation requirements resulting in denials because diagnosis codes are unable to be substantiated.
- Coders are unaware of updates or when changes occur, so don’t implement immediately prompting reduced reimbursements, claim delays or rejections.
When To Outsource Your Medical Coding
If you recently lost your home health coder or are struggling with efficiency using current coders, it may be time to outsource your coding! Interim outsourcing allows you to maintain cash flow while hiring a certified coder or until a smooth transition into the new role is achieved. Permanent outsourcing is often the best choice for your agency and provides many benefits, such as:
- Certified experienced home health coders devoted only to coding and obtaining fully optimized reimbursements
- Minimal errors and if they occur, are quickly caught and corrected
- Rapid review turnaround time of two business days with Kenyon Coding Plus, speeding up cash flow
- Clinicians are freed up to focus on client care, increasing productivity and improving retention rates
- Availability of full clinical documentation support and onsite or webinar education
- Extras including OASIS integrity reviews, plan of care and visit frequency optimization, and monthly reports tracing outcomes
If your home health coder just quit or you have less than a trained certified home health coder doing your coding, it’s time to investigate outsourcing. Contact us today to discover how our clients typically boost their reimbursement rates by up to 48%.