SafeGuard Services, LLC Issues Home Health Comparative Billing Report

In February of 2013 a Comparative Billing Report was sent to over 4,800 home health agencies.  The data in these reports were based on the average services received and paid for per beneficiary.  To provide additional education to the home health community, the data was modified and is included in the following report.  The services are based on Medicare final claims data with services dates from January 1, 2011 through December 31, 2011 and scheduled paid dates through December 7, 2012.

They issued three reports for national and state data.  The first report is the average number of home health visits per episode.  The second report is the average number of home health therapy visits per episode.   The third report is average Medicare Payment per episode.

Medicare Administrative Contractors (MACs), Zone Program Integrity Contractors (ZPICs) and Recovery Audit Contractors (RACs) utilize average data per state in determine what to audit.  They audit by exception.  For example if your agency has substantially higher visits per episode that the other agencies in your state you will be at a higher risk for an audit.  This does not mean your agency is doing anything inappropriate.  The above reports are not risk adjusted.  Risk adjusted means the fact that your agency serves patients whose diagnosis would indicate they need more visits per episode is not reflected in the reports.

We recommend you look where your agency ranks compared to your state and on a national basis on the three reports.  If you are substantially higher or lower, you may have a higher risk for an audit.  If you have such a risk ensure your documentation supports the care you have given.

To obtain the report please go to:

http://www.safeguard-servicesllc.com/cbr/faqs.asp?id=cbrfaqs2c#myfaq