Home Health PPS and OASIS-D

Home Health PPS and OASIS-D 

Reimbursement for care and services provided is an important administrative function for all home health agencies. Agencies cannot operate without revenue. While administrative staff usually perform billing-related tasks, as a clinician, you have a pivotal role in the reimbursement process. Because the majority of revenue generated by your home health agency likely comes from Medicare, it is important for you to have a basic understanding of the Home Health Prospective Payment System (HH PPS) for Medicare reimbursement. In this course, you will learn about the PPS, Medicare eligibility requirements, and the role of the OASIS in reimbursement. You will also learn strategies that you can use to help maximize agency reimbursement under the PPS.

$20.00

Hours: 1.25
REL-SRC-0-HHPOD

Certificates

Certificates provided by accrediting body (8 Match)

West Virginia Board of Registered Nursing

1.25 HOURS


American Nurses Credentialing Center

1.25 HOURS


Relias, LLC is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Nurses will receive 1.25 contact hours for participating in this course.

Texas Health and Human Services Commission

1.25 HOURS


Texas HHSC has determined that Relias Learning’s submitted training meets or exceeds the minimum standards for HCSSA administrator training in the following categories: Licensed and Certified Home Health (L&CHH). Texas HHSC also recognizes Relias Learning provides continuing education for administrators and alternate administrators. This activity is approved for 1.25 contact hours.

California Board of Registered Nursing

1.25 HOURS


Provider approved by the California Board of Registered Nursing, CEP# 13791

Nurses will receive 1.25 contact hours for participating in this course.

Georgia Board of Nursing

1.25 HOURS


Georgia Board of Nursing CE Provider #: 50-290

Nurses will receive 1.25 contact hours for participating in this course.

South Carolina Board of Nursing

1.25 HOURS


This program was approved by the South Carolina Board of Nursing Approved Continuing Education Program (CE provider #50-290) CE Broker Course # 20-[Custom_Code]

District of Columbia Board of Nursing

1.2 HOURS


DC-RN -- District of Columbia Board of Nursing Approved Continuing Education program (CE Provider #50-290).

Nurses will receive 1.20 contact hours for participating in this course.

Florida Board of Nursing

1.0 HOURS


Florida Board of Nursing CE Provider #: 50-290

Nurses will receive 1.00 contact hours for participating in this course.

Course Details

Course Code: REL-SRC-0-HHPOD
Hours: 1.25
Type: Online Course
Content Expiration Date: 11/30/2020
Learning Objectives:
Explain the situations in which 2 types of payment under the PPS would be applicable.
Describe 3 Medicare eligibility requirements for reimbursement in home care.
Identify 4 OASIS completion requirements for Medicare reimbursement.
Explore 3 strategies to use to maximize reimbursement under the PPS.

Outline:
Section 1: Introduction

About This Course

Learning Objectives

Section 2: The Prospective Payment System

The HH PPS

60-Day Episode

Case-Mix Adjustments

Low Utilization Payment Adjustment

Partial Episode Payment Adjustment

Outlier Payments

Discharge Issues

Consolidated Billing

Review

Summary

Section 3: Medicare Eligibility Requirements

Eligibility Requirements

Homebound Status

Plan of Care

Coverage for Skilled Nursing

Observation and Assessment

Managing the POC

Teaching and Training

Wound Care

Venipuncture

Other Nursing Services

Coverage for Therapy Services

The Face-to-Face Encounter

Review

Summary

Section 4: The Role of OASIS

Comprehensive Assessment

History of the OASIS

OASIS Time Points

Who Completes the OASIS?

Review

Summary

Section 5: Strategies for Success

Maximizing Reimbursement

Being Successful

Assessment Strategies

Completion of the OASIS

ADL Items

The Importance of Documentation

Review

Summary

Section 6: Conclusion

Summary

Course Contributors

Resources

References

Congratulations!

Instructor: Barbara Knott, RN, MPA, ACHCE
Ms. Knott has 36 years of experience in healthcare, with the last 34 years spent in the home care field. She has been responsible for agency regulatory and accreditation compliance as well as quality assurance programs for home health and hospice. In her current position, she has oversight of the financial, operational, and quality performance of multiple home healthcare providers. Ms. Knott has received certification as an Advanced Certified Home Care Executive. Disclosure: Barbara Knott, RN, MPA, ACHCE has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Expert Reviewer: Jennifer W. Burks, R.N., M.S.N.

Jennifer W. Burks, R.N., M.S.N. has over 25 years of clinical and teaching experience, and her areas of expertise are critical care and home health. She earned her Bachelor of Science in Nursing from The University of Virginia in 1993 and her Master of Science in Nursing from The University of North Carolina, Greensboro in 1996. Her professional practice in education is guided by a philosophy borrowed from Florence Nightingale’s Notes on Nursing, “I do not pretend to teach her how, I ask her to teach herself, and for this purpose, I venture to give her some hints.” 

Disclosure: Jennifer W. Burks, R.N., M.S.N. has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Target Audience:
The target audience for this course is: entry level Administrators; Nurses; in the following settings: Home Health.
Relias will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.
Course Delivery Method and Format
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
Relias has a grievance policy in place to facilitate reports of dissatisfaction. Relias will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias.
If you require special accommodations to complete this module, please contact Relias Support by completing the web form (https://www.relias.com/help) or by using the chat functionality.
All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
Reference herein to any specific commercial product, process, or service by trade name, trademark, service mark, manufacturer or otherwise does not constitute or imply any endorsement, recommendation, or favoring of, or affiliation with, Relias, LLC.
All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
Accommodations
If you require special accommodations to complete this module, please contact Relias Customer Support here.