Accounting Terminology
This percent is the organizations current goal for Episodic Admissions
50%
Website provided by Anthem/BCBS to assist providers on finding the home plan information.
BCBS alpha/numeric prefix directory (bcbsprefix.com)
What are the five typical services provided by Home Health Providers?
- Skilled Nursing
- Physical Therapy
- Occupational Therapy
- Medical Social Work
- Home Health Aide
What is a Benefit Period?
90/90/60
PDGM is an acronym for?
PATIENT DRIVEN GROUPINGS MODEL
Once an account balance is past this time frame, the likelihood of collecting the balance reduces significantly. The outstanding balance in this bucket should be less than 10-15% depending on payor type
AR > 120
One combined list of information, an internal document, used as a resource for insurances and where it is found.
Interim Payor List- RCM Sharepoint Site
What are COP's?
Conditions of Participation
What is the term for a voluntary action taken by the patient or representative to end hospice services.
Revocation
What is FFS?
Fee for service is a method of per visit payment. Many insurance payors reimburse in this method to reimburse each service provided to a patient.
D (DAY) S (SALE) O (OUTSTANDING)
MAC (MEDICARE ADMINISTRATIVE CONTRACTOR) for Medicare in South Carolina responsible for processing Medicare claims and responsible for providing resources and direction to home health & Hospice providers.
PALMETTO GBA
Document completed during the comprehensive assessment
What is OASIS?
What does NOE stand for?
Notice of Election
Amount of time allowed by insurance to submit claims.
What is timely filing?
This acronym identifies critical quantifiable indicators or progress toward an intended result. These indicators focus the organizations improvement and provides a list for focused department attention.
K (KEY) P (PERFORMANCE) I (INDICATORS)
Insurance companies publish this document annually to outline plan coverage and benefits.
Accrediting organization for Interim
CHAP
What does Per diem mean?
What is TOB?
type of bill
A measure of profitability that includes earnings before, interest, depreciation and amortization.
E B I D A
If it isn't (______) it didnt happen.
What is noted/documented
* The greatest resource we have are our Billing/Coordination notes
The home health plan of care outlines each disciplines plan for visits known as a (______) for a period of (_____) days
FREQUENCY / 60 DAYS
Four levels of care can be billed in hospice, what are they?
Routine, Continuous, Respite, General Inpatient.
Use this code on the NOA to identify that a patient was previously on services with another agency
Condition Code 47