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WAYSTAR FALL 2020 RELEASE
Explore the latest innovations + solution upgrades for Waystar
MEDICARE ENTERPRISE | TRANSFER DRG | PATIENT PAYMENTS | ANALYTICS
HOME HEALTH + HOSPICE RESOURCE CENTER
Everything you
need to know
about developments in home health + hospice
With changing payment models, rising AR days, shrinking cash flow and added regulations, home health and hospice providers are facing many challenges—with little time to dedicate to finding solutions. These resources are designed to help you stay up to date, reduce administrative burdens and improve your organization’s performance and reimbursement.
To learn more about Waystar’s market-leading solutions for home health and hospice organizations, click below.
Request demo
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What’s on the horizon for Medicare Advantage + Hospice Demonstration
The Value-Based Insurance Design Model (VBID Model), which began in January 2017 and will be tested through December 2024, will allow CMS to determine whether furnishing certain flexibilities in coverage and payment for Medicare Advantage organizations would:
- Reduce Medicare program expenditures
- Enhance the quality of care Medicare beneficiaries receive (including dual-eligible beneficiaries)
- Improve the coordination and efficiency of healthcare service delivery
- Promote Medicare Advantage health plan innovations
For plan year 2021, there are 19 Medicare Advantage organizations offering Medicare Advantage benefits to plan benefit packages (PBPs) with 4.6 million projected enrollees. Out of the 19, nine Medicare Advantage organizations, through 53 PBP's are participating in the Hospice Benefit Component.
CMS believes the policies being tested through the VBID Model represent an opportunity for Medicare beneficiaries who choose Medicare Advantage and elect hospice, as well as their families and caregivers, to experience a more seamless transition to hospice care with improved coordination of care.
Visit CMS for more information and a list of organizations participating in the 2021 VBID Model.
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Discover the Waystar difference
We’ve aligned our most effective claims and denials solutions to help make your organization as productive as possible. Drawing on the latest tech and predictive analytics, your team will benefit from:
RELEASE HIGHLIGHT
Optimize + simplify your Medicare reimbursements
Medicare Enterprise allows clients to connect and edit claims directly with Medicare's adjudication system, getting providers paid accurately and faster. Complete reporting and analytics delivers actionable insight to ensure clients collect the full Medicare payment.
A track record of success
We understand the growing challenges in home health and hospice care, and we have years of experience with practices like yours. Watch our video to find out how you can maximize reimbursement without adding headcount and take administrative burden off your team.
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Review Choice Demonstration support
Providers in North Carolina and Florida were able to submit pre-claim review requests for billing periods starting August 31, 2020. Other important notes:
- Claims that go through pre-claim review and are submitted with a valid UTN will be excluded from further medical review.
- Claims submitted without going through the pre-claim review process will be processed normally and will not be subject to a 25% payment reduction.
- Claims may be subject to post-payment review in the future through the normal medical review process
- Providers who have already made a choice selection do not need to take any further action if they choose not to participate.
- CMS has said it will reassess the phase-in after 60 days; check here for updates.
For Home Health providers in Illinois, Ohio and Texas:
- Cycle 2 in Illinois and Cycle 1 in Texas ended September 30.
- Affirmation and claim approval rates will be calculated based on review decisions made between February 1, 2020, and September 30, 2020, for Illinois providers and between March 2, 2020, and September 30, 2020, for Texas providers.
- Cycle 2 in Ohio began August 31, 2020.
- Claims submitted under Choice 1 without going through the pre-claim review process will not be subject to a 25% payment reduction until further notice, but will be subject to prepayment review.
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RELEASE HIGHLIGHT
Discover + recover underpayments faster
Almost half of all Medicare discharges are coded as transfer DRGs. While your health system works to recover transfer DRG underpayments, it may not find 100% of them. Start capturing all your underpayments today with Waystar.
RELEASE HIGHLIGHT
Electronic delivery of statements
RELEASE HIGHLIGHT
Electronic delivery of statements
Go paperless – it’s safe, simple + convenient. Replace paper statements sent in the mail with Waystar’s text and email delivery statements. Patients can securely view + pay statements from their mobile device or desktop with Waystar’s Patient Center/Patient Notebook eDelivery feature.
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RELEASE HIGHLIGHT
Robust data visualizations for top KPIs
RELEASE HIGHLIGHT
Robust data visualizations for top KPIs
Waystar’s new Analytics solution gives you access to accurate data in seconds with actionable insights across your entire revenue cycle. Analytics Pro can be activated in seconds, offering built- in reports and advanced KPIs* while Analytics Peak offers unlimited dashboards and report customization.*
*Existing Analytics RCM clients will be upgraded to Analytics Pro in the upcoming months and will have the opportunity to upgrade to Analytics Peak
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On-demand presentations + webinars
75%
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What Our Clients Say:
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> Download
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Key CMS updates
- CMS advanced and accelerated loan repayment/recoupment and COVID-19 implications: Under the new “Continuing Appropriations Act” of 2021 and “Other Extensions Act,” repayment for providers will now begin one year after the advanced or accelerated payments were received, according to CMS.
- Home Health Proposed Payment Rule 2021: CMS’s proposal grants the home health industry some stability during the chaos caused by the COVID-19 pandemic and the Patient-Driven Groupings Model (PDGM). If the 2021 proposed payment rule is finalized as written, providers will be allowed to use telehealth when providing care to Medicare beneficiaries even after the COVID-19 emergency subsides, which could potentially lead to payment for virtual home health care.
- Hospice Final Payment Rule 2021: In acknowledgement of providers struggles under the current public health emergency, CMS limited its final rule to “annual hospice rulemaking required by statute and essential policies as well as policies that reduce provider burden and may help providers” respond to COVID-19.
- New ABN form: CMS announced that the Advanced Beneficiary Notice (ABN), Form CMS-R-131, and form instructions have been approved by the Office of Management and Budget (OMB) for renewal. The new ABN form is effective for use on or after August 31, 2020, with an expiration date of June 30, 2023. Home health and hospice providers must use the most current form.
THE RESOURCES YOU NEED RIGHT NOW
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Get the full rundown on PDGM with our webinar
> Watch webinar
Learn more about PDGM basics
> View fact sheet
Make sure your team is ready with our PDGM checklist
> Get checklist
Three tips for transitioning to the new home healthcare landscape
> Read blog
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Results that matter. Experience that counts.
Waystar helps home health agencies significantly streamline operations while securing reliable revenue streams. Learn more by reading a couple of our success stories.
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Results that matter.
Experience
that counts.
Waystar helps home health agencies significantly streamline operations while securing reliable revenue streams. Learn more by reading a couple of our success stories.
How BAYADA decreased denial rates by 72%
> Read case study
How Preferred Home Health rebilled $4.1M in claims
> Read case study
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Key CMS updates
- CMS advanced and accelerated loan repayment/recoupment and COVID-19 implications: Under the new “Continuing Appropriations Act” of 2021 and “Other Extensions Act,” repayment for providers will now begin one year after the advanced or accelerated payments were received, according to CMS.
- Home Health Proposed Payment Rule 2021: CMS’s proposal grants the home health industry some stability during the chaos caused by the COVID-19 pandemic and the Patient-Driven Groupings Model (PDGM). If the 2021 proposed payment rule is finalized as written, providers will be allowed to use telehealth when providing care to Medicare beneficiaries even after the COVID-19 emergency subsides, which could potentially lead to payment for virtual home health care.
- Hospice Final Payment Rule 2021: In acknowledgement of providers struggles under the current public health emergency, CMS limited its final rule to “annual hospice rulemaking required by statute and essential policies as well as policies that reduce provider burden and may help providers” respond to COVID-19.
- New ABN form: CMS announced that the Advanced Beneficiary Notice (ABN), Form CMS-R-131, and form instructions have been approved by the Office of Management and Budget (OMB) for renewal. The new ABN form is effective for use on or after August 31, 2020, with an expiration date of June 30, 2023. Home health and hospice providers must use the most current form.
THE RESOURCES YOU NEED RIGHT NOW
Getting started with home health billing
> Read article
Getting started with hospice billing
> Read article
Top 5 ways your HHA is leaving money on the table under PDGM
> Read article
Best practices for new PDGM home health rules
> Read article
Your PDGM prep checklist
> Read article
How the RAP phase out will affect HHA billing requirements
> Read whitepaper
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Feature
Waystar
Other
Details
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Waytstar
Category
Average
Overall Score
95.7
87.3
% Clients Satisfied
73
N/A
Best Vendor Relationship
95.2
84.3
Product
94.2
86
Value
96.9
86.6
Operations
95.5
88.9
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Patient
Financial
Clearance
Revenue
Integrity
Claim
Management
Denial
Management
Contract
Management
Patient
Financial
Experience
Agency
Management
Patient
Insights
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Moving toward telehealth reimbursement
Home health providers are getting closer to achieving reimbursement for telehealth visits. The Home Health Emergency Access to Telehealth (HEAT) Act, a bipartisan bill proposed Oct. 23, would provide Medicare reimbursement for audio and video telehealth services furnished by home health agencies during the COVID-19 emergency.
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90%
Simo ex expercit officabori sima int
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CLAIM MANAGEMENT |
Most popular |
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Starter Simplify Denials Management |
Core Reach Workflow Excellence |
Performance Get visibility into the claim lifecycle |
Premium Achieve Revenue Cycle Automation |
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FEATURES
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ANALYTICS PRO |
ANALYTICS PEAK |
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Total savings per year
These numbers are for demonstration only and account for some assumptions. Contact us for a more comprehensive and customized savings estimate.
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At vero eos et accusamus
Sed ut perspiciatis unde omnis iste natus error sit voluptatem accusantium doloremque laudantium, totam rem aperiam, eaque ipsa quae ab illo inventore veritatis et quasi architecto beatae vitae dicta sunt explicabo.
At vero eos et accusamus
Sed ut perspiciatis unde omnis iste natus error sit voluptatem accusantium doloremque laudantium, totam rem aperiam, eaque ipsa quae ab illo inventore veritatis et quasi architecto beatae vitae dicta sunt explicabo.
Total additional revenue recovered per year
Total staff hours saved
These numbers are for demonstration only and account for some assumptions. Contact us for a more comprehensive and customized savings estimate.
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At vero eos et accusamus
Sed ut perspiciatis unde omnis iste natus error sit voluptatem accusantium doloremque laudantium, totam rem aperiam, eaque ipsa quae ab illo inventore veritatis et quasi architecto beatae vitae dicta sunt explicabo.
OUTER RANGE: Likely cash impact range for a system of your size
INNER RANGE: Most probable range given your specific information
Benefit range accounts for benefit to be attained through missing charges, CPT coding errors and DRG assignment errors. This calculator is designed to be educational in nature based upon limited information. It is therefore not a guarantee of performance. 1 HFMA blog, 2016
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Sed ut perspiciatis unde omnis iste natus error sit voluptatem accusantium doloremque laudantium, totam rem aperiam, eaque ipsa quae ab illo inventore veritatis et quasi architecto beatae vitae dicta sunt explicabo.
At vero eos et accusamus
Sed ut perspiciatis unde omnis iste natus error sit voluptatem accusantium doloremque laudantium, totam rem aperiam, eaque ipsa quae ab illo inventore veritatis et quasi architecto beatae vitae dicta sunt explicabo.