Richter ShareSource Blog

What is a Home Health Scheduler?

In this blog, we shine the spotlight on home health, and specifically, the home health scheduler, a crucially important member of your agency team. We explain the roles that this person plays; how home health care in general is covered; how visits are scheduled; service limitations; and best practice tips for scheduling that enable home health schedulers to promote positive outcomes for your agency and its patients.

A home health scheduler is the primary gatekeeper for your agency, serving as the liaison between the agency, client, caregiver and the payer. Their primary function is to schedule and manage the flow of patient care, ensuring that quality service is provided and patient satisfaction met. The scheduler provides the scheduling and coordination of the daily schedules for the following within a home health agency:

• RN case manager
• LPN
• OT, PT, ST
• Home health aides
• Social worker

Read our blog, Best Practices for Documenting Home Care Skilled Services to learn more about best practices for clinical documentation of services in a Home Health setting.  

The Home Health Scheduler is the liaison between the agency, client, caregiver and the payer.  Their primary function is to schedule and manage the flow of patient care, ensuring that quality service is provided and patient satisfaction met.  The scheduler provides the scheduling and coordination of the daily schedules of the following staff within a Home Health Agency:

• RN Case Manager
• LPN
• OT, PT, ST
• Home Health Aides
• Social Worker

Home Health Care can be covered through a number of payers; Medicare, Medicaid, Commercial, Worker’s Comp, VA and Private Pay. Payer requirements are very specific with respect to documentation of services provided.  To learn more about best practices for clinical documentation of services in a Home Health setting, please take a look at a past blog Best Practices for Documenting Home Care Skilled Care

It’s that time of year again….time to update patient insurance information.

Lack of accurate insurance information is always a challenge but particularly as we begin a new year.  Patients may change insurance carriers at the end of one year in preparation for the next.  They often neglect to inform their Hospice or Home Health provider of these changes.  In order to help ensure that the billing process is accurate and timely, it is critical that insurance information be correct.   

Patients electing the Hospice benefit can reside at any location, as long as it is a safe environment for the patient and hospice caregiver and within the hospice agency service coverage area.  If the patient is located in a Long Term Care (LTC) facility, a written agreement is required between the hospice agency and the LTC facility before services are provided.

An ADR (Additional Development Request) is a request for medical documentation to ensure proper payment for Medicare services provided.  Claims are randomly selected based on specific edits and parameters set by the Medicare Contractors. This documentation must be received on or before the 45-day due date.  Failure to do so will result in denial code 56900 which indicates documentation was not received or was not received in a timely manner.

The Centers for Medicare and Medicaid Services (CMS) requires that an OASIS is successfully submitted prior to the submission of a final Home Health claim to Medicare. Failure to adhere to this requirement could result in claim denials.