Hospice Value Base Insurance Design – VBID Pilot Expansion 2022

2021 was an interesting year for many hospices as they navigated the intricacies of billing hospice care to Medicare Managed care plans as part of the VBID pilot. Mastering the maze of participating plans, NOE requirements, claim submissions, all while continuing to bill Medicare, was challenging, and Advanced Hospice Management was with our clients every step of the way.  It took the better part of 2021 for many hospices to develop successful NOE and billing processes for those plans that initially didn’t have a clear set of instructions for us.

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Case Study: Providing Support in a Billing Transition

CASE STUDY:
PROVIDING SUPPORT IN A BILLING TRANSITION

In January 2021, Advanced Hospice Management began working with Hospice of Lansing in Lansing, Michigan, after its in-house biller retired. John Person, the executive director of the agency, needed expert revenue cycle management services and decided to consider outsourcing their billing needs. Looking for a reliable service provider that thoroughly understood the hospice billing industry, the agency contacted Advanced Hospice Management.

“We’ve been extremely happy with the service, responsiveness, industry knowledge and professionalism of AHM.”

CHALLENGES

  • The previous biller retired and the agency was unsure how to move forward with its billing processes.
  • The complexity of the role made it difficult to assess the ability of a new hire.
  • The agency needed an experienced and reliable billing service that it could trust and rely on.

OUR SOLUTIONS

  • Provided the agency with a seamless onboarding process, as well as professional insights and resources.
  • Maintained clean accounts receivable.
  • Educated the agency about its processes.
  • Formed a strong relationship with the agency, providing dedicated billing services, high responsiveness and organizational support.
  • Managed electronic medical records and files for Medicare and Medicaid billing.

“They have some insights about how you can do something better and how to smooth that out, and that has been helpful. We have a very good relationship and we enjoy the individuals that we work with.”

RESULTS

  • By closely monitoring claims and managing electronic records, Advanced Hospice Management enhances the agency’s overall billing process.
  • Advanced Hospice Management’s high responsiveness and reliable support provide the agency with peace of mind knowing that its billing services are well managed.
  • Advanced Hospice Management oversees all bill discrepancies and effectively communicates, manages and corrects issues, creating a steady flow of revenue for the hospice provider.

Advanced Hospice Management has helped the agency understand and enhance its overall billing processes. We were able to use their current electronic medical record (EMR) system, providing the agency with a seamless onboarding process. Along with hospice billing services, we have also been able to provide the agency with recommendations and outside resources to improve other aspects of their operations.

“There's no question they know their stuff and have been
an incredible resource for us.”

What We Learned From the Pilot Program

On January 1, 2021, CMS began testing the inclusion of the Part A Hospice Benefit within the MA benefits package through the Hospice Benefit Component of the Value-Based Insurance Design (VBID) Model. This test allows CMS to assess the impact on care delivery and quality of care, especially for palliative and hospice care, when participating Medicare Advantage (MA) plans are financially responsible for all Parts A and B benefits.

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Specialization Leading to Quality Results

Specialization

When searching for a billing solution for your business, it is incredibly important to go with a company that specializes in your field. There is a notable difference between the service offered by a specialized billing company and the service offered by a company that focuses on multiple healthcare verticals for billing. Think quality versus quantity. Wouldn’t you rather quality when it comes to your billing solutions?

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Outstanding Balances Without Solutions

Outstanding Balances without Solution

At Advanced Hospice Management, we understand that outstanding balances with no solution are frustrating. Oftentimes, the reasons for these unpaid bills are confusing or vague. Our job is to go above and beyond to figure out why the claim was really rejected, and correct the process to ensure smooth sailing going forward. Let our team help you maximize your billing solutions by following up on unpaid claims until they are corrected.

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Systematically Tackling Unbilled Claims

At Advanced Hospice Management, we understand the overwhelming feeling that unbilled claims bring to our clients. That’s why we have developed a system to handle unbilled claims where we work side by side with our clients to review each claim one by one.

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