PointClickCare is equipping home care providers with the necessary tools and resources to thrive under the Patient Driven Groupings Model (PDGM). With PDGM’s implementation date looming, providers need effective strategies to navigate this new payment model. PointClickCare’s comprehensive platform and resources address these challenges head-on.
Streamlining Operations and Ensuring Compliance with Point Click Care PDGM Tool
PointClickCare’s home care platform offers a suite of features designed specifically to address the complexities of PDGM. These enhancements enable providers to:
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Optimize Revenue Cycle: Streamline billing processes with efficient handling of two Requests for Anticipated Payment (RAPs) and final claims for each 60-day episode of care, reducing days to bill and accelerating revenue collection.
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Enhance Communication: Improve collaboration between team members with intuitive dashboards that minimize back-and-forth communication regarding pre-billing requirements.
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Reduce Outstanding Claims: Leverage automated workflows for monitoring requirements, generating and submitting claims, and automatically posting cash receipts, leading to faster payment and improved cash flow.
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Ensure Compliance: Minimize returned claims and maintain regulatory compliance through automated validation of payer requirements.
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Monitor LUPA Performance: Track Low-Utilization Payment Adjustment (LUPA) percentages and thresholds per clinical grouping and 30-day billing period to identify potential financial risks.
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Compare Reimbursement Impact: Analyze the financial impact of PDGM by comparing case-mix reimbursement under the previous Prospective Payment System (PPS) model with projected payments under PDGM.
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Proactive LUPA Management: Access LUPA thresholds for each 30-day billing period before finalizing the Outcome and Assessment Information Set (OASIS) or Plan of Care, enabling proactive adjustments to avoid LUPA penalties.
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Expedited Admissions: Utilize the intake workflow to efficiently document admission information, including timing, and seamlessly transfer relevant patient data from Skilled Nursing Facility (SNF) records to Home Health charts, reducing days to admission.
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Accurate Clinical Grouping: Identify the appropriate clinical grouping based on the primary diagnosis, guiding care teams towards accurate coding and preventing claim rejections due to unacceptable primary diagnosis codes.
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Seamless Order Management: Integrate with an automated order tracking system to streamline the process of sending, managing, and receiving physician orders, ensuring timely and accurate documentation.
Beyond the Platform: Resources and Support for PDGM Success
PointClickCare extends its commitment to PDGM preparedness beyond its platform enhancements. Providers have access to a comprehensive library of resources, including:
- Informative Webinars: Gain valuable insights and practical strategies for PDGM success through expert-led webinars.
- Comprehensive eBooks: Deepen understanding of PDGM requirements and best practices with detailed eBooks.
- PDGM Calculator: Utilize a dedicated calculator to analyze CMS’ Agency-Level Impact information for 2019, facilitating informed financial planning.
PointClickCare: Empowering Home Care in the Value-Based Care Era
PointClickCare’s commitment to innovation and provider support positions home care agencies for success in the evolving healthcare landscape. By leveraging the PointClickCare platform and resources, providers can confidently navigate the complexities of PDGM, optimize financial performance, and continue delivering high-quality care. For more information on PointClickCare’s PDGM solutions, visit their website.
