It’s unknown if CMS plans a continuation and/or expansion of Review Choice Demonstration (RCD) in 2024 – and that’s beside the point. Even if you’re not a home healthcare business, Forcura recognizes that all healthcare organizations’ operations can benefit from what the leaders of Gaffey Home Nursing and Hospice, Concierge Home Care and HealthRev Partners shared during our recent thought leadership webinar, “Protect Your Payments: Lessons Learned from Review Choice Demonstration.”
Why It Matters
The intended consequence of the five-year CMS Review Choice Demonstration pilot was to reduce fraud in the home health sector. The unintended consequences for many agencies who operated in the pilot area and complied with the reg were:
- Highly efficient operations which yielded more accurate and timely clinical documentation,
- Tighter processes among their clinical, intake and billing staff,
- Improved education and collaboration with referring and signing providers,
- Clean claims and full reimbursements, and
- (The holy grail) better patient care.
How They Got There
The panelists all started by thoroughly documenting each part of the full referral-to-claims submission process within their organizations. They identified and eradicated duplication. They identified lead teams and taught accountability. They educated their sales teams and referring and signing providers on the documentation and timing required to care for patients. They synched their intake, field clinicians and billing teams so patient conditions captured on the front end were accurately coded on the back. And they used real-time data to locate bottlenecks and maintain alignment across their organizations.
Was this expensive? Absolutely. Most say their administrative costs were far higher as they worked through perfecting their processes at the pilot’s start.
Yet all called out how the right technology can eliminate much of that administrative cost, expedite processes with fewer staff, accelerate sent-to-signed times for care plans, and improve their bottom lines.
To a woman, each panelist pointed to Forcura as that tech partner. Since the launch of RCD, Forcura’s healthcare workflow solution has gotten smarter, leveraging AI to present data for decision making. And Forcura has gotten faster, eliminating fax entirely for both home-based care agencies and their signing providers so care plans can be sent, reviewed, signed and returned with digital ease.
Go Deeper
Don’t wait to apply the lessons our panelists shared. Protect your payments no matter what regulation – or inefficient operation – threatens your margins. Ask for a demonstration today.
