Homecare Audit Prevention: Compliance Tools to Protect Your Medicare Payment

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Homecare Audit Prevention: Compliance Tools to Protect Your Medicare Payment

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Homecare Audit Prevention: Compliance Tools to Protect Your Medicare Payment

 

By Annette Lee, RN, MS, COS-C, with contributions
from Wayne van Halem, AHFI, CFE


Home health care is under more layers of regulatory scrutiny than ever before. Plus, under health care reform, the Department of Health and Human Services will mandate that agencies have compliance programs in place. Homecare Audit Prevention is a one-of-a-kind manual that gives you guidance and tools to avoid compliance problems that could jeopardize payment.

Part I outlines the current audit threats to the industry—including RACs, MACs, and ZPICs. Part II provides a sound structure to model or refine your Medicare compliance program to minimize audit risk. The companion CD-ROM is chock full of customizable compliance checklists, forms, and tests to educate staff and monitor care delivery and documentation. Use this manual to:

You will learn how to:

  • Implement or refine a Medicare compliance program to avoid audit scrutiny
  • Protect appropriate payment by ensuring services are reasonable and necessary
  • Compare and contrast the threats posed by new, renamed, and existing auditing bodies
  • Learn ways to prevent and respond to RAC, MAC, and ZPIC audits
  • Educate, monitor, and test your staff’s comprehension of care delivery and documentation with customizable tools


The binder includes valuable forms and checklists, including:

  • Personnel Records
  • Agency Education
  • Agency Policies and Procedures
  • Supervisory Review of Documentation
  • Justify Home Health Aide Services
  • Restorative Therapy Services
  • Physician Orders
  • Coordination of Services
  • Home Health Aide Assignment and Supervision
  • Patient Rights Notification During Initial Visit


Ideal for homecare administrators, directors, quality improvement managers, staff educators, compliance officers, and risk managers.

ISBN: 978-1-60146-762-1

Pages: 300

Published: September 2010