Are You an Advocate For Seniors?

I have a few things that really bother me personally.  Taking advantage of people particularly children, the disabled, and senior citizens.  Recently I found an advertisement for a computer for senior citizens.  This computer had a list price of around $1,300 and was on sale for around $1,080.  Sound great, but a laptop computer with much more speed, memory and features could be purchased for around $500.  I saw another advertisement for a senior cell phone plan that was also much more expensive for similar plans available from other carriers.  Does this offend you?  It definitely offends me.

My clients provide services to senior citizens, people with disabilities, and children.  Do you advocate for them to ensure they are treated fairly.  A good example is Medicare which was established to provide coverage for many services for people 65 and over and for some people who are disabled.  How is the Medicare program treating the providers, physicians and suppliers of these services?  In recent years with RAC, ZPIC, CERT, and MAC audits of claims, I would say they are treating all of them very poorly.  It appears that they are Guilty until proven innocent with potentially many years before a fair hearing. 

Now back to being an advocate. Let’s try to advocate for our senior citizens, people with disabilities and children.  Did you know that the fasting growing percentage of people using Facebook are seniors.  Do you and your employees volunteer at the senior centers, community centers, assisting living facilities, or personal care homes.  Maybe that might be a good idea.  You and your employees have tremendous amounts of expertise disease management, diet, exercise, and medication compliance.  You also have employees who could teach seniors how to use computers and other technology.  You could teach classes on Facebook and other software.  You could show the elderly where and what technology they could purchase and at a fair price.  Let’s all become advocates for senior citizens, people with disabilities and children with critical needs. We have found that it we receive more than we give when we spend time with our Seniors.  We think that you will also.

We have two excellent speakers that will present topics on Marketing, Branding, Leadership and Social Media at our four Las Vegas Seminar in late January and early February.  Richard Martin has worked with companies around the nation helping them to promote their business.  Cheri Martin is an expert in Facebook, LinkedIn and Twitter and has help companies to learn how to add these skills to their marketing plan.  They will present several sessions that will help you implement these skills and techniques to your company.  There is more information about the seminar below.

Dixon Healthcare Solutions, Inc. Next Destination Seminars  Exploring Trends & Routes for Success

Four Great Seminars presented by  Dixon Healthcare Solutions, Inc. Home Health Agencies - January 28-30, 2015 Physicians Practices - January 28-30, 2015 Hospices - February 2-4, 2015 Private Duty - February 2-4, 2015 **** Brochures Home Health Brochure Physician Practice Brochure Hospice Brochure Private Duty Brochure **** Location is the Monte Carlo in Fabulous  Las Vegas, NV **** Registrations Forms Home Health Physician Practices Hospice Private Duty It is important to register early, because the rates go up as the date gets closer and their is limited seating. **** The speakers include: Richard Dixon, J-non Griffin Robert Liles Richard Martin Cheri Martin Robert Floyd Donna Floyd Adam Bird (Physician Practice Only) **** Program Outlines Home Health Physician Practice Hospice Private Duty The program is great for each and we hope to see you in Las Vegas at the Monte Carlo ***********************************

Hospice’s Are You Ready For Big Changes Beginning on October 1st

October 1st is only 8 days from now.  

• Are you ready for the big changes for hospice?  
• Do you know about the new penalties for late filing of Notice of Election?  
• Are you aware of the changes in allowable primary hospice diagnoses? 
• Have you reviewed the new payment rates beginning October first? 

If you answer no to any of the above you need to watch the recorded webinar titled "Final Hospice Rules & Rates for 2015".   This one hour On-Demand webinar will cover all of the above and much more.  You and your entire company can view the recorded webinar for a flat fee of only $199.  That includes multiple viewing as many times as you would like!  You will receive 5 different handouts in PDF form that go with the webinar.

I have recorded a brief 2 minute video to explain the webinar.  You may view the 2 minute video by clicking the link below:

Two Minute Video 

To registered for the recorded webinar please click on the

Registration Link

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New Survey and Enforcement Requirements

Home health agencies, hospices, hospitals, physician practices and other providers have been under increased government and government contractor scrutiny.  They have dealt with increased claim audits by RACs, ZPICs, and CERTs.  These contractors are bounty hunters, meaning they get paid based on the number of claims they deny.  Many of the denials have been labeled as questionable by providers and physicians.  The MACs (Medicare Administrative Contractors) have supported these denials in the lower level appeal process forcing appeals to the Administrative Law Judge.  This has overwhelmed the Administrative Law Judge system.  Appeals that were required to be heard within 90 days may not be resolved for many years.    Hospitals have obtained a potential settlement offer from CMS to pay for 68% of claims that have been denied for patient admitted prior to October 1, 2013.  CMS has not made this proposal to home health, hospices or physicians. This settlement may reduce the potential ALJ backlog, but will not eliminate the backlog. Now home health agencies are facing more stringent surveys with enhanced penalties.  Look for this to be the next arrow from CMS's quiver to reduce the number of home health agencies.  I have personally had more calls about survey problems this year than my last 5 years in business.  Home health agencies must ensure they are complying with all the conditions of participation and to document this compliance.  If your agency does have a survey with deficiencies you will be required to write a plan of correction. J'non Griffin a 26 year veteran of home care will present a session titled Home Health Intermediate Sanctions in our "Exploring Trends and Routes for Success" a comprehensive seminar for Home Health which will be held in Las Vegas, NV on January 2015. The session will explain and identify intermediate sanctions.  It will also show how to develop a suitable corrective action plans.  This timely session will provide information that is crucial for all home health agencies. There is more information about the seminar below.   **********************************************

Exploring Trends & Routes for Success

Four Great Seminars presented by Dixon Healthcare Solutions, Inc. Home Health Agencies - January 28-30, 2015 Physicians Practices - January 28-30, 2015 Hospices - February 2-4, 2015 Private Duty - February 2-4, 2015 Location is the Monte Carlo in Fabulous Las Vegas, NV It is important to register early, because the rates go up as the date gets closer and their is limited seating. Registrations Forms Home Health Physician Practices Hospice Private Duty The speakers include: Richard Dixon, J-non Griffin Robert Liles Richard Martin Cheri Martin Robert Floyd Donna Floyd Adam Bird (Physician Practice Only) Program Outlines Home Health Physician Practice Hospice Private Duty The program is great for each and we hope to see you in Las Vegas at the Monte Carlo ***********************************

Hospice Medicaid Rates For 2015

CMS issued the final Medicaid Payment Rates for Hospices on September 5th 2014.  They provide rates for Hospices that have submitted quality data and reduced rates for hospices that did not submit quality data.  The rates must be adjusted based on location by wage index values.  They also provided the Medicaid Hospice per patient cap for the year ending10/31/2014.

Table 1 Hospice Medicaid Payment Rates (Submitted Quality Data) 

Description                                 Daily Rate             Wage          Non-Wage

Routine Home Care                           $159.55              $109.63                 $49.92

Continuous Home Care (24 Hr)         $930.27              $639.19               $291.08

Continuous Home Care (Per Hour)     $38.76                 $26.63                 $12.13

Inpatient Respite Care                       $173.48                 $93.91                 $79.57

General Inpatient Care                      $708.77               $453.68               $255.09

Table 2 Hospice Medicaid Payment Rates (Quality Data Not Submitted)

Description                                 Daily Rate             Wage          Non-Wage             

Routine  Home Care                       $156.42               $107.48                   $48.94

Continuous Home Care (24 Hr)       $912.05               $626.67                 $285.38

Continuous Home Care (Per Hour)    $38.00                $26.11                   $11.89

Inpatient Respite Care                     $170.08                 $92.07                   $78.01

General Inpatient Care                     $694.88              $444.79                 $250.09

Medicaid Hospice per Patient Cap Year 11/1/2013 to 10/31/2014 is $26,725.79

For More Information use this Link

How Clearinghouses Can Improve Your Collections

Over my many years of experience as a Chief Financial Officer and health care consultant I have found that dealing with private insurance and Medicare Advantage billing and collections is a nightmare.  Before we had clearinghouses most claims were sent in via paper.  Once you mailed in the paper claim the collection nightmare began.  You would wait for 30 days and call the insurance company to check the payment status on your claim.  They would say they did not receive the claim so you would mail them a new claim.  You would wait 30 days and call the insurance company to check the payment status on your new claim and you would be told they had not received your claim.  This process would continue for several more attempts to submit the paper claim.  When the claim was six month old the insurance company would tell you that your claim was not timely filed and would be denied.  Now remember you probably submitted this paper claim at least 5 times. 

One thing to always remember about private insurance and Medicare Advantage companies is they do not make money paying claims.  They make money collecting insurance premiums and avoiding to pay claims.  Failure to meet timely filing is one of their all-time favorite excuses for not paying claims.

Now what happens if you use a clearinghouse to submit your claims? First your claim is submitted electronically.  If you use the right clearinghouse you will be able to obtain proof of timely filing of the claims which eliminates the situation above.  Next most clearinghouses have some electronic edits built into their software.  You will know right away if your claim failed to meet their edits.  I have seen cases where it was taking 90 days to pay a paper claim from a particular private insurance company and if that same claim was submitted electronically via a clearinghouse it would be paid in two weeks. 

Remember that clearinghouses will not correct low payment rates private insurance companies and some Medicare Advantage companies are paying for your services.  They will not eliminate the deductible and coinsurance the insurance companies are requiring to be paid from the patient, but you should have a better record of submission of your claims and any reasons for denials.

The use of a clearinghouse could cost your company as little as $100 per month, which is well worth the price. I have utilized ZirMed and have been very happy with their services.  I have also used Office Ally.  There are many other clearinghouses such as Emdeon, Apex EDI, and Gateway EDI.  I would check with the company that provides my billing software and see which clearinghouses they currently utilize.

I do not recommend trying to obtain higher volume of private insurance and Medicare Advantage patients, because for many of these patients you will actually lose money.   I have a session titled Financial Strategies to Increase Profitability in our “Exploring Trends and Routes for Success” Home Health Seminar which will be held in Las Vegas, NV on January 28^th to January 30^th . The session will shows methods to utilize to increase your home health agency profits and how to determine which patient to market and which patients to avoid.  

New Hospice Medicare Cost Report

CMS issued the final rules for freestanding Hospice Medicare Cost Reports on August 29, 2014.  This new cost report is effective for hospices that have fiscal years beginning on or after October 1, 2014.  That means the first full year cost report will be filled for fiscal year ending September 30, 2015.   Link for More Information We had a webinar titled  "Final Hospice Payment Rules and Rates for FY 2015"  The Recorded Version is now available For more information please see below: **********************************************

Final Hospice Payment Rules and Rates for FY 2015

We have an On Demand Webinar  This 60 Minute Webinar covered the following items.  1. The New Hospice Payment Rates for FY 2015     2. Trends in Medicare Hospice Utilization    3. Hospice Payment Reform Analysis     4. Definitions of "Terminal Illness" and "Related Conditions"    5. New Timeframes for Hospice Cap Determinations & Overpayment Remittances    6. Notice of Election and Notice of Termination/Revocation Time Limits  7. Adding the Attending Physician to the Hospice Election Form    8. Proposed Update to the Hospice Quality Reporting Program       This Webinar can be viewed at any time because it was recorded.  Your registration fee is only $199 for your entire company.  The registration fee also will include handouts that you will receive via email when you register.    To attend the exciting new Webinar please download the Registration Form and fax it back to us at (888) 445-3965We do accept all major credit cards.   You can register by phone by calling (321) 473-8561 and asking to speak with Margaret. Registration Form *********************************

October 1, 2014 Big Date for Hospice

October 1, 2014  Big Date for Hospice

Normally October 1st is a big date in the hospice industry, but this year it is much more important.  The new hospice payment rates start October 1st, new rules filing Notice of Election including penalties for late filing, changes in the hospice cap, and changes in allowable primary diagnosis.  We have a recorded seminar titled "Final Hospice Rules & Rates FY 2015".  You can view this anytime on demand.  It is imperative that all hospices understand the potential impact of these rules.  You and your entire company can view the webinar for a flat fee of $199.  That includes multiple viewing as many times as you would like for that price.  You will receive 5 different handouts to go with the webinar.   Link for More Information We had a webinar titled  "Final Hospice Payment Rules and Rates for FY 2015"  The Recorded Version is now available For more information please see below: **********************************************

Final Hospice Payment Rules and Rates for FY 2015

We have an On Demand Webinar  This 60 Minute Webinar covered the following items.  1. The New Hospice Payment Rates for FY 2015     2. Trends in Medicare Hospice Utilization    3. Hospice Payment Reform Analysis     4. Definitions of "Terminal Illness" and "Related Conditions"    5. New Timeframes for Hospice Cap Determinations & Overpayment Remittances    6. Notice of Election and Notice of Termination/Revocation Time Limits  7. Adding the Attending Physician to the Hospice Election Form    8. Proposed Update to the Hospice Quality Reporting Program       This Webinar can be viewed at any time because it was recorded.  Your registration fee is only $199 for your entire company.  The registration fee also will include handouts that you will receive via email when you register.    To attend the exciting new Webinar please download the Registration Form and fax it back to us at (888) 445-3965 We do accept all major credit cards.   You can register by phone by calling (321) 473-8561and asking to speak with Margaret. Registration Form