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HH05: Home Health Claims (1/2)

Petria September 3, 2020

Course Catalog | Module 5 Study Guide

In this course students will learn about the life cycle of the claim from the time it’s submitted to the time its paid. Learn the differences between electronic and paper claims submission. Explore the various billing software including the Direct Data Entry (DDE) and MAC portals. Will look at the eligibility requirements and different OASIS’s types. Students will get an understanding of the 60-day episode life cycle, form CMS-485, Face to Face requirements, the free software Haven provided by Centers for Medicare and Medical Services (CMS), and the Home Health Care Survey (HHCAPS).

Students will learn about the documents needed before billing and clinical documentation needed for billing. Discuss how clinical and billing interact and what verbal orders are. Students will explore the diagnosis codes, revenue codes, HCPCS codes, G codes, Q codes and other billing codes as well as the billing process.