Home Health agencies are under constant scrutiny from Medicare. With increased audits,
stricter billing rules, and evolving CoPs, even the best-run agencies can make costly
compliance mistakes. In this blog, we break down the top seven errors that put your agency
at risk and how you can fix them before they become a liability.
CMS requires a physician face-to-face encounter before certifying eligibility for Home Health
services. Delays or incomplete F2F documentation are a common audit trigger.
Fix: Implement automated tracking systems and designate a compliance officer to oversee
timely submission.
It’s not enough to say the patient is homebound—you need clear, clinical evidence.
Fix: Train clinicians to document specific limitations and provide supporting examples.
OASIS affects payment and quality scores. Mistakes here can cascade into both compliance
and revenue issues.
Fix: Use a dual-review process for all OASIS assessments. Consider an external QA partner
like Trilogy.
A vague or insufficient POC could be considered noncompliant.
Fix: Review every POC for scope, frequency, goals, and measurable outcomes
From unsecured communication to access control lapses, HIPAA violations can be costly.
Fix: Conduct annual HIPAA training and perform regular risk assessments.
If the patient doesn’t meet Medicare’s skilled need criteria, services will be denied.
Fix: Use evidence-based tools to justify skilled care and train staff to document accordingly
Unannounced surveys can reveal overlooked problems.
Fix:Conduct internal mock surveys every quarter and prepare staff with scripts and
education.
Avoiding these seven mistakes can mean the difference between thriving and surviving.
Medicare compliance is non-negotiable. Trilogy Quality Assurance can help you create a
proactive, agency-wide compliance culture.
Health care is a vital aspect of maintaining overall well-being, encompassing a range of services from preventive care
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