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CLINICAL SERVICES FOR HOME HEALTH AGENCIES

Correct Coding Directly Impacts Home Health Agency Success

One of the biggest challenges of in-house coding is attracting and keeping experienced coders. Rest easy knowing that each coder working on your account has been thoroughly assessed and trained regularly.

Our thorough review process will further improve the quality of your clinical documentation, which will lead to accurate claims, ensuring you receive the reimbursement you earn.

Cliniqon offers a complete and systematic approach as we review patient charts along with Coding, OASIS (SOC, ROC, RCT, SCIC) Review, POC Review and/or Creation, Discharge OASIS Review for Star Rating Management, and Concurrent Document Review.

HOME HEALTH & HOSPICE CODING

We assure you of unparalleled quality work delivered within 12 to 24 hours.

Cliniqon is a committed and trusted partner focused on revolutionizing healthcare better outcomes through advanced technology and knowledge. Our in-depth healthcare industry expertise enables us to provide end-to-end solutions to successfully resolve our clients’ billing challenges while embracing their overall business operations and more importantly giving their patients the care, they deserve.

With proven quality and a strong financial ROI, Cliniqon delivers unmatched competence, proven accuracy, and faster turnaround times.

The well-rounded experience of our team with advanced degrees, maintained certifications in medical coding and health information management will partner with you to develop a program that fits your agency’s specific needs to deliver:

  • ICD-10-CM coding compliance
  • Reduced AR backlogs
  • Best practices for EMR-specific coding workflows
  • Improved quality of care
  • Dedicated quality team
  • Flexible solutions for any size agency
  • Robust dashboard and benchmark reporting
  • Cost-effective and highly scalable operations to ensure consistent cash flow
  • Reduced turnaround times

ICD-10-CM CODING

Don’t settle for code compliance. Strive for coding excellence

ICD-10-CM codes are important because they are more granular than ICD-10 codes and can provide more information about the severity of a patient's condition. This has impacted Health Care Providers in a variety of ways. From payment to claims processing systems to heightened specificity of clinical documentation, every aspect of the revenue cycle and patient management cycle has been affected.

Our Home Health coders are highly qualified and proficient Registered Nurses (RNs) with Home Health Coding Certification and are up to date with PDGM Guidelines by CMS.

OASIS (SOC, ROC, RCT, SCIC) REVIEW

We will help your agency get ahead of the game

Our Coding and QA department is comprised of experienced, industry-leading specialists—certified RNs—who are available to elevate your agency’s coding approach and accurately evaluate the quality of your current OASIS process.

  • Comprehensive OASIS and Plan of Care Review of Start of Care, Resumption of Care, Recertification, and Other Follow Up Assessments
  • Overall and Concurrent Clinical Documentation Review
  • Appropriate, Valid, and Reimbursable PDGM Diagnosis Codes

Each member of our team is well-trained and knowledgeable on OASIS Review as we make sure that the intent of each item is understood to better educate the clinicians. We also ensure that responses to each OASIS item are supported by the patient’s chart.

OASIS DISCHARGE REVIEW FOR STAR RATING MANAGEMENT

Ensure OASIS Accuracy. Implement Clinical Best Practices. Leverage Technology Solutions.

We help agencies achieve and maintain a higher Star Rating by carefully reviewing the patient’s chart, especially the clinician’s notes within the qualified timeframe and by providing more appropriate responses to relevant OASIS items that affect the Star Rating.

POC Review and Creation

We review and create a comprehensive and patient-specific POC within the 5-day time frame.

Concurrent Document Review

Concurrent Document Review includes, but not limited to:

  • Medical Records – Patient Profile, Admission Consent, H&P, Progress Note, F2F, Referral, etc.
  • Nursing, Therapy, MSW, HHA Visit Notes
  • Physician Order
  • Communication Log
  • Medication Profile
  • 60-Day Summary
  • Infection Report
  • Incident Report

FREQUENTLY ASKED QUESTIONS

OASIS stands for the Outcome and Assessment Information Set. It is a tool designed by CMS to collect information regarding a home care recipient’s demographic information, clinical status, functional status, and service needs.

Quality Assurance (QA) involves assessing the quality of services delivered to ensure they meet or exceed desired standards, as well as evaluating whether home health agencies are compliant with industry regulations.

It is the process of applying universal alphanumeric codes that correspond to medical procedures, diagnoses, services, and equipment.

It is a tool designed by CMS to collect a patient’s demographic information, clinical status, functional status, and service needs.

A home health coder is a healthcare professional responsible for assigning diagnostic and procedural codes to patient records in home healthcare settings.

The primary diagnosis is the one most associated with the current home health plan of care.

Start of Care (SOC) is the initial assessment and services provided to a patient when they begin receiving care.

ROC stands for Resumption of Care. It involves re-evaluating a patient’s condition and needs after a temporary interruption or change in care.

Recertification is the process of confirming a patient’s need for continued home health care services and is required at least every 60 days following the initial certification period.

A transfer is the movement of a patient from one care setting into another, such as from one home health agency to another or from the hospital to a patient’s home. Discharge occurs when a patient is released from home health services.