Home health solution enhanced to support CMS CR-8441 and HIPPS codes for Medicare Advantage claims
ATLANTA – June 30, 2014 – Brightree, the leading provider of cloud-based clinical, billing and business management software solutions for the post-acute care industry, announced today that, in advance of the July 1, 2014, deadline, its Brightree Home Health solution is compliant with the Centers for Medicare & Medicaid Services (CMS) change request 8441 (CR-8441) and also includes updates to support the inclusion of Health Insurance Prospective Payment System (HIPPS) codes on Medicare Advantage home health claims.
“Regulatory compliance regarding claims is extremely vital to home health agencies in order to prevent potential penalties and ensure timely claims processing and payment,” said Steve Rogers, vice president of product management at Brightree. “To support these new industry regulations, we have optimized our home health solution, enabling customers to take advantage of automated processes and streamlined workflows to ensure claim accuracy and completeness and avoid rejections.”
CMS CR-8441 requires that home health claims with episodes that begin on or after July 1, 2014, must report the National Provider Identifier (NPI) and name of the physician who certifies/re-certifies the patient's eligibility for home health services if this physician is different than the attending physician who signs the patient's plan of care. In addition, home health agencies must continue to report the NPI and name of the attending physician who signs the patient's plan of care.
Medicare Advantage plan claims must have a Health Insurance Prospective Payment System (HIPPS) code for home health services in order for home health agencies to be reimbursed for services delivered. Medicare Advantage claims with dates of service of July 1, 2014, and beyond will be rejected without the appropriate HIPPS codes.
How It Works
The Brightree Home Health solution has been enhanced to support the CR-8441 regulation by including the ability to capture the certifying physician when the certifying physician is different than the attending physician who signs the patient’s plan of care. The solution will automatically compare the certifying physician who signs the face-to-face encounter to the attending physician who signs the plan of care and, if they are different, will place both the certifying and attending physician names and NPI numbers on electronic and paper-based Medicare claims to streamline workflow and eliminate claim submission errors.
Additionally, the solution has been enhanced to support the Medicare Advantage HIPPS Codes regulation by calculating the HIPPS code from the home health Outcome and Assessment Information Set (OASIS) and automatically including the calculated code on Medicare Advantage home health paper and/or electronic claims. For those Medicare Advantage plans that require information in addition to the HIPPS Codes, the solution uses a configurable approach to allow additional data to be included on the claims.
Brightree will be demonstrating its Home Health Solution in booth #421 at the upcoming National Association for Home Care & Hospice (NAHC) Financial Management Conference and Exposition on July 13 – 15, at the Chicago Marriott Downtown Magnificent Mile Hotel in Chicago, Ill.
About Brightree LLC
Brightree is the leading provider of cloud-based software to improve clinical and business performance in the post-acute care industry. The Company serves more than 3,000 organizations in the home medical equipment (HME), home health, hospice, orthotic and prosthetic (O&P), HME pharmacy, home infusion and rehab home care segments. Brightree’s solutions follow the natural workflow of providers to automate and improve how they manage their businesses, serve patients, and protect reimbursements. The company is ranked as one of the top 100 healthcare IT companies in the U.S. on the prestigious Healthcare Informatics 100 (HCI 100) list. For further information, visit www.brightree.com or call 1.888.598.7797.