With the 2021 RAP payments reducing from 20% of HHRG value to 0%, its more important than ever to monitor and benchmark unbilled activity for your agency. Consulting Director, Brian Harris and Consulting Manager, Jordan Cichon will examine key elements and pre-bill processes to monitor RAPs, NOEs and Final Claims. We will be reviewing all of the pre-bill requirements impacting timely submissions of Home Health and Hospice claims, recommendations on how to efficiently manage these, and best practice benchmarks for unbilled claims/outstanding orders.

We’ll provide guidance toward developing the most effective method to manage unbilled claims and EMR structure to ensure compliant and efficient billing. Timely submission of claims is pivotal to consistent cash flow and success!

Key Takeaways

  • Track and manage unbilled AR by reason
  • Escalate unbilled AR over 30 days
  • Submit No-Pay RAPs for MSP patients
  • Utilize your EMR pre-bill audit features to streamline the billing process
  • Hospice Orders are not required to be signed before billing

BlackTree Recommends

  • Monitor unbilled A/R on a daily basis to identify any potential impacts to cash flow
  • Cleary delineate responsibilities for issues preventing billing
  • Use the valid primary diagnosis received with referral when billing RAPs
  • Create a tracking log for both no-Pay RAPs and NOEs to ensure they are billed timely to avoid any payment penalties
  • Bill Home Health Medicare claims daily
  • Key RAPs and NOEs in DDE on day 5

 

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