Home Health Medical Coding and OASIS Review Services

What we do

Maintain compliance with our cost-efficient home health medical coding services

Partnering with us forms an alliance, creating strong synergies and efficiencies that will deliver the necessary performance to support and enhance our client’s reputation. We offer a strategic partnership to enforce chart documentation compliance review and functional assistance in achieving effective Offshore Home Health Medical Coding, Compliance, and QA services.  

 

LKN Strategies is a home health revenue cycle management service company who has institutionalized security controls as per HIPAA Guidelines and has developed various controls required under the security controls framework.

 

Our Solution

Home Health Medical Coding and OASIS Quality Assurance

LKN Strategies’ Home Health Medical Coding Services guarantees standardized, compliant, and accurate reimbursement. The reimbursement scene for home health has never been easier, especially with new payment complexity, ongoing staffing challenges, and ongoing coding updates with the help of our team of expert medical coders. We provide a holistic and systematic approach as we review patient charts along with Coding, OASIS (SOC, ROC, RCT, SCIC) Review, POC Review and/or Generation, Discharge OASIS Review for 5-Star Rating Management, and Concurrent Document Review. 

LKN Strategies combines highly specialized skills, best practices, and advanced technology as proven methods to address your agency’s specific issues and challenges to provide you the best results with these services

ICD-10-CM CODING

ICD-10 coding performed by experienced certified RNs who can assist your clinicians to ensure accuracy. Under PGDM, ICD-10 coding is crucial for obtaining the reimbursement you deserve. We work with you together with our highly skilled team of certified coders and with advanced technology to develop a program that suits your agency’s specific needs to provide:

  • Qualified and experienced Registered Nurses (RNs) with Home Health Coding Certification who are up to date with ICD-10 and CMS PDGM Guidelines 
  • Ongoing training & quality improvement 
  • A team of clinical professionals who are certified coders with years of experience of  the latest regulations and committed to the highest quality standards 
  • Systemize workflows 
  • Comprehensive capacity with flexible solutions for any size agency

 

OASIS (SOC, ROC, RCT, SCIC) REVIEW

These services are performed by experienced certified RNs who can assist your clinicians to ensure accuracy, clinical compliance, and optimized reimbursement. Each member of our team is well-trained and experienced in OASIS review to ensure accurate documentation based on the patient’s individual needs. We also ensure that responses to each OASIS item are supported by the clinician’s documentation and physician progress notes and history and physicals. Getting fair and accurate reimbursement starts with accurate clinical documentation. Since reimbursement is centered on value-based purchasing, the importance your agency puts on achieving accurate clinical documentation is critical.

 

LKN Strategies’ certified medical coders provide extensive OASIS review making the most of its advanced technology and proven best procedures to ensure you receive the most appropriate payment and quality outcomes by following the best practices:

  • Emphasizes OASIS items affected by payment, 5-star ratings and VBP, as well as other aspects of concern to the agency 
  • Delivers extensive, tech-empowered understanding, providing intelligible dashboards and standardized reporting 
  • Achieves success continually through clinical documentation by recognizing continuing improvements of clinicians and actionable recommendations

 

DISCHARGE OASIS REVIEW FOR 5-STAR RATING MANAGEMENT

We help agencies achieve and maintain a higher Star Rating by carefully reviewing the patient’s chart, especially the clinician’s notes, within the qualified timeframe and by providing more appropriate responses to relevant OASIS items that affect the 5-Star Rating.  

Your agency can be assured that this can be achieved with help of our team by:

  • Assessing your agency’s current best practices for patient care 
  • Ensuring that quality measures are targeted in the services that you offer 
  • Explore opportunities of improvement to ensure that your agency follows through on its improved quality of care

 

POC REVIEW AND GENERATION

Our clinically certified team will review all necessary documents and assist your agency’s staff in completing a compliant and defendable Plan of Care. We review and generate a comprehensive and patient-specific POC within the 5-day timeframe. LKN provides a Plan of Care Review based on your agency requirements to meet your clinical staff needs and instantly decrease the Clinical Manager’s workload.  LKN reviews the plan of care for errors, omissions, and discrepancies with the interventions, goals, frequency and duration of treatment, verbal orders, and face-to-face (FTF) encounter. We’ll take care of your agency by: 

  • Improving clinical outcomes  
  • Lessening clinical manager’s workload 
  • Securing accurate payment 
  • Reducing multiple corrections to improve efficiency  
  • Elimination of inconsistent and inaccurate documentation

 

HOME HEALTH COMPLIANCE

Staying on top of the ever-changing policies and regulations in Home Health is LKN Strategies’ top priority. Our compliance services make sure that any unforeseeable conflicts are avoided by tackling issues head on for, minimizing errors and diminishing potential obstruction in workflow, allowing consistent, timely, and compliant home health services. 

Our team works 24/7 to provide you with only the best outcomes with the following services:

  • Staying up to date on all CMS regulations and other payer policies
  • Thoroughly review your agency’s compliance program
  • Prevent lapses in compliance by staying up-to-date with current guidelines

 

Improve quality and consistency in all aspects of RCMs

HOME HEALTH QUALITY ASSURANCE SERVICES

Our Quality Team performs 100% audit on all the charts to ensure that the standard of quality requirements by CMS are met. Effective corrective action plans take place immediately and are consistently monitored.​ All QC processes are performed in-house and there is no external QC vendor deployed. The current turnaround time for QC is within 24-48 hours with the following services assured:

  • Consistent Chart Audits (Daily, Weekly, Monthly)​
  • For each customer, we perform service level agreement (SLA) Metrics and Key Performance Indicator (KPI) monitored with highest level of focus with exclusive representatives for Operations, Quality, Knowledge and Training. ​
  • LKN Strategies Inc. operations are day-to-day under Compliance production and Quality Assurance and requirements.  Broadly, the LKN Strategies Inc. Quality Assurance program consists of 4 facets:​

Maintain Compliance with our cost-efficient home health medical coding services.

Guarantee success no matter what stage you are at in starting a home health care agency with our knowledgeable and experienced certified consultants.
LKN Strategies

5 STAGES OF CMS APPEALS

STAGE
1

Redetermination

When initial review is denied for PCR; PPR; ADR; UPIC; RAC, etc. and providers of the claim is denied, you have 120 days to submit a Redetermination Request (30 days from date of initial decision demand to avoid recoupment). This request is handled by the Medicare administrative contractor (MAC). If the claim is denied you have 60 days to submit an appeal request to level 2 to avoid recoupment.
STAGE
2

Reconsideration

Reconsideration is step 2 in the appeals process. You have a maximum of 180 days to submit your appeal. You will submit your documentation with the request for reconsideration and a detailed "rebuttal" of the reason(s) you disagree with the decision made at level 1. This review is completed by qualified independent contractors. If denied, you may move to stage 3. You have 60 days from date of receipt of Reconsideration.
STAGE
3

AU

At level 3 you will have a chance to present your appeal case to an Administrative Law Judge. You will need to submit a request and a detailed rebuttal as to why you disagree with the level 2 appeal decision. Your claim will only be elevated to level 3 if it meets the minimum dollar amount. For 2022, the required minimal amount is $180.00 If denied, you may try stage 4. You have 60 days from date of receipt of AL decision.
STAGE
4

MAC

The Medicare Appeals Council reviews the appeal decision made by the AU. If the claim is denied, you have 60 days to submit a request for judicial review by a federal district court.
STAGE
5

Federal Court

To get a judicial review in federal district court, the amount of your case must meet a minimum dollar amount. For 2022, the minimum dollar amount is $1760. You may combine claims to meet this dollar amount. Follow the MAC's decision letter you received at level 4 tafileacomnaint.
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