Common Home Health Billing Mistakes and How to Prevent Them

It is quite common for home health agencies to struggle when it comes to accurate billing and coding processes. If payment-related issues are not appropriately addressed, they can result in missed income opportunities. Because of this, it's critical to have a home health billing system that works well and prevents errors at all costs.  

Are You Making These Errors in Home Health Billing?  

Medicaid funds may be improperly paid for home health services if they are disbursed to the incorrect organization, paid in error, lack supporting documentation or policy, or are used for services not specified in the person-centered plan. To identify the underlying reason for payment errors for agency-provided goods, appliances, equipment, and home health services, Payment Error Rate Measurement (PERM) data was examined. Two common flaws were found by the analysis: incorrect unit of measurement and inadequate

Number of unit errors:  

When a provider invoices for the wrong number of units for a procedure code, it's known as a number of units error.   

When it comes to home health services and agency-provided supplies, appliances, and equipment, common mistakes include:   

• Billing for more units than what is documented for a procedure code;   

• Billing for more units than what is authorized by the doctor's order in the person-centered plan; and   

• Not properly dividing overnight services into daily units. The right procedure code and number of units are billed in error;   

• The units are not calculated appropriately for the procedure code, such as when units of service are billed in 15-minute increments although the requirements stipulate one hour;   

• The documentation must reflect the date span for accurate billing. 

  
  

Inadequate documentation:  

When a provider presents documentation that does not fully support the procedure code billed, this is known as an inadequate documentation error. Typical mistakes regarding home health services, agency-provided tools, supplies, and appliances consist of:   

• The service provider's name, service dates, amount of time spent, and completed tasks are absent from service logs. Records weren't endorsed by the supplier or approved by the recipient;   

• The progress notes do not specify if the billable services were rendered, are not signed, or are absent.   

• Absence of physician authorization  

Alleviate Home Health Billing with Sunknowledge  

Navigating through the complex maze of home health billing is something that requires a special skill set and knowledge. With the evolving healthcare regulations and guidelines, providers are struggling to balance care quality and functionality of the practice.   

However, a reliable outsourced revenue cycle management organization like Sunknowledge Services Inc. can ease your pain by eliminating the mistakes within your practice’s operations.   

The team of expert medical billers and coders has been serving providers across the country with utmost precision and excellence to enhance care and revenue simultaneously.   

You can connect with Sunknowledge experts to better understand how they can transform your ROI in a positive direction in the long run.