Low Volume Appeals (LVA) Initiative Settlement Option, Part 3

The Low Volume Appeals Settlement Process, also known as LVA, is a new option for agencies who are waiting for ALJ hearings or MAC/DAB reviews. Take advantage of this opportunity to settle fully-denied claims. When to apply for Low Volume Appeals Settlement The dates to apply for this new CMS initiative are here! Based on... Continue Reading →

Breaking News: Newly Filed Bill Revises HHGM

A bill designed to keep the federal government funded through March 23 has several provisions involving home health, including revisions to the face-to-face requirement and the addition of a new payment model similar to the Home Health Groupings Model (HHGM).

Low Volume Appeals (LVA) Initiative Settlement Option – Part 2

The Low Volume Appeals Settlement Process, also known as LVA, is a new option for agencies who are waiting for ALJ hearings or MAC/DAB reviews. Take advantage of this opportunity to settle fully-denied claims.  

Low Volume Appeals (LVA) Settlement Option – Part 1

Introducing the Low Volume Appeals Settlement Process, also known as LVA. This is a new option for agencies who are waiting for ALJ hearings or MAC/DAB reviews. QIRT highly recommends you take advantage of this opportunity to settle fully denied claims.   CMS has just provided a new avenue for agencies stuck waiting for Administrative Law... Continue Reading →

Why Your P&P Manual Must be as Unique as Your Agency

With the new Conditions of Participation (CoPs) going into effect January 13th, QIRT consultants have been receiving multiple calls from current and potential clients requesting that we provide them with a new policy and procedure manual that covers the new COPs. On the surface, this seems like an easy enough request - for a fee, QIRT... Continue Reading →

QIRT’s Joe Osentoski Discusses Targeted Probe and Educate

Home Health Care News consulted Reimbursement Recovery and Appeals Director, Joe Osentoski for his knowledge of CMS' Targeted Probe and Educate audits. In an article dated December 11, 2017, Carlo Calma detailed some of the regulation changes brought about by CMS and spoke to experts about the impacts they are seeing in the industry.

Targeted Probe and Educate: What It Is and What It Isn’t

CMS has replaced the Progressive Corrective Action (PCA) ADR/Medical Review process with Targeted Probe & Educate (TPE). With this change comes a different approach to reviews and how Additional Development Requests (ADRs) are sent to agencies. Much of PCA is still present, but with some key changes, so TPE is not the same old process. Check out our comprehensive list of what TPE IS and what TPE IS NOT.

Emergency Preparedness Checklist

Completing the new Emergency Preparedness Plan (EP) for your home care agency is not an easy task and the time to finish is now. Caution should be used in preparation. Begin with QIRT's checklist.

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