Byline: Misty Skinner, Executive VP of Services, HEALTHCAREfirst

With PDGM implementation right around the corner, it’s important that agencies understand home health billing basics to reduce errors – as they can cost you a significant amount in penalties and fees. A large portion of these improper payments was likely due to mistakes. Thus, demonstrating a critical need for accurate billing.

But before you can reduce errors, you have to know where the mistakes are. These are three common mistakes found in home health billing:

Duplicate Claims Were Submitted

According to CGS, many home health claims are rejected because they are duplicates of claims already submitted – typically a result of lack of organization on the agency’s part. Many agencies struggle with having a streamlined process that facilitates accurate billing.

Beneficiary Eligibility Was Not Verified

CGS also says that another reason for rejected claims is when the beneficiary information on the claim doesn’t match the eligibility record at the Common Working File (CWF). This is an important step in making sure that claims are paid, but can often be overlooked when there is a large batch of bills to be submitted.

Physician’s Orders Are Missing or Incorrect

This means that the physician’s orders did not include a physician signature dated prior to billing, or they did not cover the services to be billed. Accuracy is key to getting reimbursed for all of the services you provide.

Each of these mistakes have one thing in common: human error. With so many tasks, it’s no wonder data gets entered incorrectly or claims get submitted multiple times. Streamlining your processes means reducing your errors. And that means more of your focus can be on what’s important – your patients.

Want to learn ways to reduce these errors? Visit our Educational Resources page – designed to keep you informed on the latest regulatory changes, best practices, and tips for improving performance.