Tuesday, January 10, 2012

Are your vendors prepared for ICD-10?

Are your vendors prepared for ICD-10? 

This question may be on your mind lately, which is a good thing. Making sure your vendors are prepared for ICD-10 is crucial and should be as soon as possible.

Unfortunately, many home care professionals can’t say that their vendors are prepared and ready for ICD-10. When we asked this question during our ICD-10 survey at the 2011 NAHC Annual Show, nearly half (46%) said “no” or “not sure” if their vendors are prepared.

We need to get this number way down. Talking to your vendors is one of the first things you should do in your ICD-10 planning to make for a smooth transition.

When you ask your vendors (point of care, EHR, billing, etc.) what they are doing to prepare, they should be able to tell you their clear plan leading up to implementation and how they will support you during the transition. If they cannot, you may want to consider an alternative vendor.

CMS has provided more detail on what specifics you should discuss with your vendors here.

And check out our helpful list of 9 other things you should be doing now to make for smooth transition.

Tuesday, January 3, 2012

Defining Homebound

With many conflicting ideas,  interpretations, and vague guidance, determining if a patient is homebound can often be challenging.

Some will automatically assume a patient is not homebound if they hear they drove or left the house. But this isn’t necessarily true. A December 2010 survey we conducted to test home care professionals knowledge of homebound confirmed this notion. We found many people jumped to the conclusion that a patient was not homebound if they left the house for any reason or drove. 

Home care professionals are doing patients a disservice by not knowing the proper homebound definition. With a clearer understanding of what it is, patients can get the care they really need.

We shared Medicare’s specific homebound definition previously on our blog here. In summary, just because a patient leaves the house, or even drives, it does not mean they are not homebound. For one, any excursions related to medical appointments or religious activities cannot be taken in consideration  to a patient’s homebound status. Also, it says that a person is homebound if leaving “requires a considerable and taxing effort.” So perhaps they did drive to the grocery store, but if it took them 30 minutes to get into the car and needed the assistance of a friend or relative, they may be homebound.

The problem arises is how do you prove a “considerable and taxing effort”? The answer is documentation. Instead of saying it was difficult for a patient to get around the house, you can be more specific and say the patient was “unable to ambulate more than 100 feet without having to rest.” Its all opinions until you give quantities and specifics and even then you may still have a patient who is on the fence because there are not specific guidelines on what physical limitations qualify  someone homebound There will be some judgment calls. But with documentation which quantifies the physical or sometimes mental limitations you then have  proper documentation to back it up your decision.

Understanding homebound status will not only help us provide better care for in-need patients, but it will also save money in the long run. For example, if a patient is disqualified from homebound status, then they must leave the house frequently to receive all care and/or they miss critical appointments, which can cause them to take a downturn and end up in a hospital or nursing home. This would be much more expensive than if they got their care in the home and were able to heal there.

If you still have questions about homebound status, please contact us at nick [at] daymarck.com.