Services Offered

Services We Offer

We code and QA at multiple levels for Start of Care (SOC), Resumption of Care (ROC),
REC (Re-Certification), and SCIC (Significant Change in Condition).

Level 1

Coding only

Level 2

Coding & OASIS Review

Level 2.5

Coding & Comprehensive OASIS
Review

Level 3

Coding, Comprehensive OASIS
Review & Plan of Care (POC)

Level 3.5

Coding, Comprehensive OASIS
Review, POC & Pre-Billing QA

Level 4

Coding, Comprehensive OASIS
Review, POC, Pre-Billing QA
& QA Notes

Other

Creating CMS 485, PHO &
SCIC Order & OASIS-E Discharge
& Transfer Review

Our Comprehensive Services

Coding Services

Our home health coding team is a dedicated group of professionals committed to ensuring accurate and efficient medical coding for home healthcare services. Composed of experienced and certified coders, our team reviews patient records and documentation to assign appropriate codes that reflect the care provided. They stay up-to-date with the latest coding guidelines and regulations, ensuring compliance and maximizing reimbursement. Their expertise in ICD-10, combined with a deep understanding of home healthcare nuances, enables our organization to maintain high standards of quality and accuracy. Highly experienced coders with Home Health Coding Certification, proficient in ICD-10 and CMS PDGM guidelines.

Regular coding audits to maintain accuracy and compliance
Systemized workflows for enhanced efficiency
Comprehensive capacity with flexible solutions tailored for agencies of any size

PDGM

Our service is meticulously designed around the Patient-Driven Groupings Model (PDGM), ensuring home health agencies receive optimal reimbursement while delivering high-quality care. We focus on precise patient classification based on clinical characteristics, functional levels, comorbidities, and admission sources, in alignment with PDGM’s 30-day payment periods. Our experienced coders manage clinical groupings and functional impairment levels expertly, ensuring accurate and compliant coding. We conduct thorough reviews of OASIS and coding, provide detailed analysis of visit notes and documentation, and offer recommendations to improve accuracy and optimize reimbursement.

OASIS Accuracy

OASIS (Outcome and Assessment Information Set) review is a critical component of our service, essential for ensuring accurate and comprehensive assessment in home health care. Our team carefully examines OASIS documentation to validate clinical data, evaluate patient needs, and refine care plans accordingly. By conducting thorough OASIS reviews, we not only ensure compliance with regulatory requirements but also enhance the quality of care delivered to patients. Our expertise in OASIS enables us to identify areas for improvement, support clinical decision-making, and ultimately contribute to better patient outcomes and satisfaction. We review various types of OASIS records including Start of Care (SOC), Resumption of Care (ROC), Recertification (REC), Significant Change in Condition (SCIC), discharge, and transfer.

Completion within 48 hours turnaround time
Achieving 98% accuracy in OASIS and Coding (mandatory for all coders)
Reviewers possess an average of over 10 years of experience in home health
Proficiency across various software platforms

Pre-Billing QA

Our comprehensive and precise pre-billing quality assurance includes a detailed review of patient records from the ground up. We start by meticulously verifying coding accuracy to ensure compliance with regulatory requirements. Our comprehensive OASIS review involves a deep analysis of clinical data to assess patient needs and enhance care planning. We seamlessly integrate the plan of care, which is tailored to each patient’s individual needs and designed to promote recovery, maintain health, or manage chronic conditions effectively within the home setting, ensuring it aligns with documented assessments. Additionally, we carefully create CMS 485 or post-hospital orders to accurately reflect prescribed care and services. Through these rigorous checks and balances, we not only optimize reimbursement but also uphold high standards of care delivery in the home health industry.