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Pre-Claim Review Non-Affirmations

You are already familiar with the Home Health Review Choice Demonstration and Home Health Pre-claim Review Submissions. Recently, PalmettoGBA (PGBA) released some important information regarding Pre-Claim Review (PCR) Non-Affirmations that pertains to home health agencies in Illinois and will soon apply to Ohio agencies as well. This is valuable insight into what PGBA is looking

2020 Medicare Home Health PPS Proposed Rule

This home health proposed rule’s 346 pages (reduced from last year’s 600) were published on July 18. Comments will be accepted from now until September 9, 2019. You can submit your comment by clicking on the “Submit a formal comment” link near the top of the article. You can also send your comments by regular

State and National Resources for Clinicians

From time to time, we receive inquires from our users with clinical questions. Though our team possesses a treasure trove of knowledge in different aspects of home health, including Medicare home health care, early intervention (EI), pediatric therapy, outpatient therapy and more, we are not clinicians. However, we do want to give our users the

What is MIPS?

The Merit-based Incentive Payment System (MIPS) is a Quality Payment Program (QPP) developed by CMS to get providers to focus on performance improvement by paying bonuses to providers who perform well in certain measures. There are four domains that clinicians report on with each accounting for a percentage of your overall score: Quality, Improvement Activities,

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