Our clinical services are focused on assisting you in providing quality patient care in an efficient and cost effective manner. HMA assists clients in preparing for regulatory accreditation surveys. We provide clients with an objective assessment of Agency operations and proven methods of quality improvement in patient care, documentation, operating systems, productivity and new program development. Some examples of HMA's clinical services include;
Diagnoses Coding Services
Accurate coding is not only a regulatory requirement, but also has a significant impact on your reimbursement. HMA qualified staff of certified home health coders (HCS-D) can provide your agency with the following services;
- Entire comprehensive assessment review to identify appropriate diagnosis codes to place on the assessment.
- Our coding service is usually combined with OASIS review to ensure a more comprehensive, accurate assessment which includes assignment of diagnosis codes.
- Quick review process.
- You will receive results of our coding no later than two business days from when we received your assessment information.
- We can review your assessment data via a variety of mechanisms including:
- You can fax the information to us.
- We can access your software. (if remote access is possible)
- Submission of review results via email to your agency’s specified contact person for the assessing clinician’s review/approval for codes assigned.
- Periodic feedback on recommendations for opportunities to improved the quality of your assessment documentation.
Use of HMA’s comprehensive assessment forms, if you choose to do so.
Compliance Review Services
- Clinical record documentation review to evaluate medical necessity and homebound status at Start of Care and Recertification.
- On Site; or
- Records can be submitted to our office.
- Evaluate records to identify patterns of ""red flags"" related to medical necessity such as:
- 5 visit episodes (rather than a 4-visit LUPA)
- 6, 14, or 20+ therapy visits billed.
- Number of continuous episodes per patient.
- Number of continuous episodes for one service, such as PT
- Evaluation of billing practices related to;
Presence of signed and properly dated physician orders prior to billing.
Comparison of services billed to clinical documentation.
Written reports to provide feedback related to:
Quality of documentation;
- To support homebound status
- To support medical necessity of services provided
Patterns of ""red flags"" related to medical necessity.
Recomendations for improvement.
Provide staff trainging related to Medicare eligibility criteria.
- On-site survey readiness assessment.
- Mock survey (including staff home visits and record review)
- Staff education related to Medicare Conditions of Participation (COP).
- Recommendations for process revisions to facilitate COP compliance and continual survey readiness.
- Written reports to provide feedback related to:
- Potential deficiencies.
- Priority issues that need addressing.
- Recommendations for improvement / COP compliance.
- Operations Management
- Management Training
- Disease Management Programs
- Quality/Outcomes Improvement
- Regulatory Compliance
- Federal/State Survey Preparation
- Diagnoses Coding
- Utilization Review
- Process Analysis
- Forms Review and Design
- Productivity Improvement
- Medicare Coverage
- Continuing Education Programs
- Clinical Policies and Procedures
- Accreditation Preparation
- Comprehensive Assessment / OASIS Review
- ADR Assistance
- Compliance Audit