As regulations change and documentation requirements change to become more stringent, many agencies can be slow to adapt. This may not have an immediate effect, but during a Medicare ADR cycle or during a chart review by a Medicare Advantage plan, ensuring compliance is going to either help you keep the reimbursement you earned or create a takeback liability. Don’t get caught off guard…be ready now.
Use the next two months to tweak your referral process and make sure that all staff are educated in these areas: Face to Face – anyone and everyone in the agency should know what needs to be there. Review of 485s and orders – clear, concise signatures and dates and billing requirements. Authorizations … are staff getting the correct authorizations or pre-authorizations and do clinical and clerical staff know where to find them in a patient chart?
Requirements change and so do documentation standards. Avoid unnecessary recoupments and loss by being prepared. If you face resistance on this topic from any staff member, it might be time to also evaluate that staff member to see if their part of the team to work for and with your agency or a potential weak link that could work against it.
Take the time to develop clear and concise job aids for your staff to follow. Each position should have complete policies and procedures for every task documented. This includes step by step instructions on how to complete a task with the forms needed, information needed and how to use your software correctly. On top of this, the policy needs to be defined and clearly explained. Consider a frequently asked question (FAQ) section for the job aide of common issues that pop up. The goal is to make sure staff do not have to make uninformed decisions that could put your agency at risk. Once a job aide is complete, have a staff member who doesn’t perform those functions and duties follow the guide.
If that staff member has questions or is confused, go back over the job aide, make changes and repeat until someone totally new to your agency is able to pick up that job aide and do the job necessary. A well-known secret about larger, multistate agencies is that detailed job aides and guides are provided to all staff for every position. This process driven methodology allows an agency to grow as volume grows, also known as scaling.
The purpose of scaling is to focus on policy and procedures not on an individual. An individual will eventually move on either within the agency or elsewhere and the work needs to continue. This type of mindset allows your agency to focus on scale not individuals. Rely on policies and procedures, not on an individual. This can be hard for agencies to change, but by doing so, your agency – your business, will be stronger.