Home Health PDGM

• Faster Time to RAP
• Software that understands PDGM in the Office and at the Point of Care
  • Support for data entry in the office to support reduce data entry by clinicians in the field
  • Instantly be warned of non-qualifying primary diagnosis codes during data entry
  • See what secondary diagnosis codes qualify for co-morbidity
  • See projected HIPPS and Reimbursement at the Point of Care and the Back Office
  • Identify physicians referring patients with non-qualifying primary diagnosis codes

It is possible to thrive under PDGM and HealthWare can help by providing the highest levels of automation that support the needed PDGM workflow. Whether your agency is small or large, it’s important that you understand how PDGM is affecting your agency and HealthWare can help with insightful analysis. HealthWare is ready to assist you with what you’ll need to thrive under PDGM.

• Features like our PDGM Calculator which help you understand the factors affecting your reimbursement.
• We built our own PDGM Grouper allowing us to utilize it throughout HealthWare. Our analysis services use our grouper, billing uses our grouper and we have also integrated the grouper into HealthWare’s clinical features so that clinicians can preview the resource group and calculated payment. Using our unique PDGM Calculator you can quickly see how any changes in the diagnoses or functional level affect the payment.
• We validate for qualifying primary diagnosis codes right from the start to make sure you are aware of any diagnosis codes that won’t qualify for billing under PDGM and we do that today so you can better become aware of what codes will have to be under PDGM. We can even help with coding diagnosis codes that will qualify under PDGM.
• We show you co-morbidity qualifying diagnosis codes and if you have a high, low or no adjustment.
• Features to support non-clinical staff collecting and entering information such as medications, diagnosis codes and more.
• Features to support scribing which allows the nurse to go onsite while someone in the back office fills out the OASIS and other clinical forms.
• Use our built in Clinical Assistant at the Point of Care and Back Office to do automated OASIS QA and other clinical validation. We also interface to several third-party OASIS scrubbing and analysis tools such as OperaCare and SHP.
• We support entering primary diagnosis code plus 24 secondary diagnosis codes both in the back office and at the point of care.
• We check for Low Utilization Payment Adjustments (LUPA) thresholds and alert you if one will be triggered by a change in a patient projected, scheduled and actual visits.

• HealthWare can help you thrive under PDGM
• Utilize our EMR software to streamlines the process and provide insight into your operations
• Utlize our services to help offload tasks such as intake and billing so you can concentrate on patient care
• We can combine our technical and analytical expertise with our partners to provide you even more resources