Nov 27, 2020

For RAPs with “From” dates on or after January 1, 2021, the up-front split-percentage payment for all 30-day periods of care will be lowered to zero for all HHAs (newly-enrolled and existing). Generally, a RAP and a claim will be submitted for each 30-day period of care. RAPs are submitted at the beginning of each 30-day period.

RAPs are submitted when:

• The appropriate physician’s written or verbal order that sets out the services required for the initial visit has been received and documented as required; and

• The initial visit within the 60-day certification period has been made and the individual is admitted to home health care.

Starting in CY 2021, a payment reduction will apply when the HHA does not submit the RAP within 5 calendar days from the start of care date. The payment reduction will be equal to a 1/30th reduction to the 30-day period payment amount for each day.

With the above facts from Medicare, there is an increased pressure on the Home Health Agencies to have the orders in place from Physician and submit the RAPs promptly to avoid reduction in payments. With the Clarus partnering with you:

• The OM (Orders Management) will be done within 72 hours.

• RAPs will be entered into DDE timely.

• Required fields for RAP will not be missed.

• Steps will be taken to ensure information is on file pertaining to all data elements for the RAP.

• Exceptions are documented aptly in case of delays in submission by keeping mind the qualifying circumstances.

With the team having expertise in SOC,QA, OASIS, ROC review the initial billing needs are met efficiently for the Home Health Agencies.