PPS: Prospective Payment System Cash Finally Begins To Flow

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article covers the early rollout of revised Medicare prospective payment system processing for home health agencies, with emphasis on claim holds, intermediary updates, software corrections, and ongoing billing workflow issues. It is aimed at home health billing staff, agency administrators, and reimbursement professionals tracking payment system changes and claim processing disruptions. The piece also discusses broader operational impacts, including resubmission challenges and the need to reconcile processed claims with expected reimbursement.

Why This Topic Matters

It helps readers understand whether the payment system issues affecting home health claims are being resolved and what operational areas still require attention. The article is relevant to organizations managing Medicare home health billing, claim follow-up, and revenue cycle workflow during system transitions.

What You Will Learn

  • How the revised prospective payment system is affecting home health claim processing
  • What types of claim and software issues were being reported by intermediaries and vendors
  • Which operational areas in home health billing were still causing delays or reconciliation challenges
  • How payment system changes can affect agency billing workflows and management attention

Who Should Read This

  • Home health agencies
  • Home health billing staff
  • Revenue cycle managers
  • Medicare reimbursement professionals
  • Agency administrators

Codes Discussed

  • Unspecified: 32038
  • Unspecified: 30720

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