by Wyn Staheli, Director of Research
December 4th, 2019
With the transition to the new case-mix classification model, the Patient-Driven Groupings Model (PDGM) just around the corner, now is the perfect time to preview Find-A-Code’s home health PDGM Calculator (also known as the HIPPS calculator) for Medicare! Plug in your numbers and see just HOW your payments will be affected. No more pie in the sky guessing.
Plug in different values and see how your payments will be affected. There’s no need to mess up billing systems with trial and error. This calculator makes it easy.
Home healthcare agencies have the option of billing just the HIPPS code instead of running all the individual values through a billing system’s grouper program.
If you are still struggling with questions, be sure to check out the MedLearn call presentation “Home Health Patient-Driven Groupings Model: Operational Issues” (see References below) which covered the following topics:
- Billing and claims processing overview
- Requests for Anticipated Payment (RAPs)
- How OASIS data will be used in the claims system
- Reporting new occurrence codes
- Period timing scenarios
- Admission source scenarios
- Transition scenarios
As a reminder, CMS has changed the unit of the home health payment from a 60-day episode to a 30-day period. When using the calculator, be sure that you enter the “Number of Visits” based on 30 days instead of 60 days.