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Overview of Home health Software

This healthcare market continues to grow as health care shifts from the hospital to the home. Like many healthcare professionals, these workers need to speed up patient encounters, while providing better care. Providers also face the added challenge of being constantly on the move. Fortunately, home health agency software is designed to automate many of the day-to-day activities professionals encounter - from completing clinicals to scheduling and billing. We have created this guide to help buyers better understand this software market and how to identify which systems will best meet their needs.

What is Home Health Software?

It generally includes features typical of most electronic health records (EHRs) to streamline the day-to-day clinical operations of providers. More specifically, these systems have been designed to automate nearly every process needed in home care - ranging from clinicals, or point-of-care records to billing, scheduling, and accounting. Most systems are designed take you through the Home Health Care Outcome & Assessment Information Set (OASIS) - while keeping patient data secure and HIPAA-compliant. Some home health systems offer unique features designed to meet the needs of specialty areas, such as physical therapy, occupational therapy, speech-language therapy, or others. Deployment Strategies

When selecting a solution, buyers can choose to implement applications for specific tasks - known as standalone, best-of-breed solution. Or, they can go with an integrated system that has a full suite of tools to address all of their needs - such as accounting, billing, human resources, and more. Agencies also need to determine how they would like to access the system. For example, some systems are offered completely over the Internet as web based home health software systems. This is also referred to as a software-as-a-service (SaaS). These SaaS systems are typically offered in a pay-as-you-go monthly or annual subscription and are hosted and maintained by the vendor. Other vendors offer on-premise solutions where users install and run the system from a server at your agency.

Application Categories

Point of Care

Assists in conducting and capturing information from OASIS assessments and in determining a Plan of Care. Helps with completing HCFA-485 forms, OBQI reports, and HHRG scoring. Stores notes from home aides, hospice, therapists, and information on patients’ vitals. Functions include internal messaging, medication interaction checks, mobile device and telephony support, and infusion therapy support. Also features signature capture, physician portal, ICD-9 database and HL-7interface.

Billing

Home health billing software manages eligibility verification, claim scrubbing, and CMS-1500s. Includes case mix calculator and non-LUPA case adjustment. Functions include ERN posting and electronic remittances, secondary payer support, request for anticipated payment (RAP) support, collections management, billing services, and UB-04 support.

Scheduling

Home health scheduling software manages the process of scheduling patients to ensure accuracy of daily calendars. Features include conflict alerts and wait lists.

Accounting

Automates accounting procedures for agencies. Functions include payroll, general ledger, purchase orders, accounts payable, and inventory control. Also handles bank reconciliation, accounts receivable, fixed asset management, and budgeting / forecasting.

Human Resources

Assists in routine activities including health care provider background and security checks, tracking time and attendance tracking, and payroll. Handles I-9 forms, certification tracking and review management.

Customer Relationship Management(CRM)

Helps coordinate care of patients across specialties, departments and locations, improving the impact of your referral program. Aids with correspondence related to wait lists for hospices with limited space and to donor management for organizations receiving charitable contributions.

What Type of Buyer Are You?

Before evaluating software and lining up a formal comparison of systems, you’ll want to make sure you know what type of buyer you are, and which home health software vendors meet your needs. We’ve found almost all buyers fall into one of the four categories listed below:

accounting, billing, and customer relationship management. Therefore, integrated suites are ideal for these buyers.

Market Trends You Should Understand

Buyers should keep the following trends in mind when researching software. How a vendor fits within these trends can affect its viability.

Implementing Home Care Software

You've selected new Home Health Care Software and/or Hospice Software. Now what? The next step in the process is implementation. This is an area where there are many agencies that excel, and others that feel completely overwhelmed. You've spent a lot of effort to find the perfect home care software solution for your business. Now that you've got it, what do you do with it? Some agencies proceed thinking, "Now I'll get trained and I'll be on my way." However, that's not all that is involved.
Here are some suggestions on ensuring that your software implementation goes smoothly and without hiccups, thus ensuring that your agency and staff are successful product users.

Engage your team early in the deployment process. Share with them all of the wonderful ways the system will help them. Acknowledge that it will be change, and it will take effort, but as an organization you're committed to making it successful. To do so, you need their help. Encourage them to embrace and evolve with the changes. The end results will help them, the agency and most importantly, your patients.

What "has been" doesn't have to be what "IS." (Look at your processes… now is a great time to change them and make them work even better!) Align your processes and people to exploit the best aspects of your new software. Just be careful of trying to change too much at one time.

Going from paper to electronic is a big change. Try to keep in mind that it's not always appropriate to do/keep all of the same paper processes and procedures as you move into the electronic world.

Ask your vendor for their recommendations and suggestions. They've helped hundreds of agencies implement their solution. What are the things they've seen work? What things have they seen that didn't work out so well? This will help you make more informed decisions.

Implementing a new system takes effort. In many cases you've put a significant investment in selecting a homecare software vendor. Rushing or short-changing the implementation process can take your beautiful new system that you worked so hard to select and leave you with less than optimal results. A solidly configured system that is used well by your users will increase your ROI and likely, the happiness of your organization.

Support your implementation team. Generally, agencies don't have people on-staff that are able to focus all of their time on the software implementation. Ensure that the individuals who are working on the project and leading the internal efforts have Executive support and are empowered to make decisions. Take time to make sure they feel appreciated.

Expect a couple of bumps. What major change doesn't involve at least a bump or two? This doesn't mean to expect a derailment but do expect a couple of bumps. If they don't happen, that's awesome! If you see a "bump" in the road coming, call it out. Determine a mitigation plan. Can you take a "detour?" Should you "slow down" so you don't hit it at 75mph? Making informed decisions will help you and your agency minimize the overall effects of the bump.

Chart your progress. Celebrate the milestones as an agency. It's exciting to be implementing something new!

At the conclusion of your implementation you will look back and recognize some lessons learned, but more importantly see a more efficient and better ability to focus on patient care, not on paperwork.

Best Practices for Working with Commercial Payers

Medicare continues to reduce payments, forcing Home Health agencies to look for other ways to maintain revenue and profits. One alternative source of revenue to consider is commercial payers. To be successful when working with commercial (private insurance) payers your agency will need to be organized and well prepared. Here are some recommendations to help you get started.

Know Your Market Find out which insurance companies operate in your area. Typically, these should include Medicare Advantage providers, Medicaid HMOs and straight commercial care companies.

Contracting with Commercial Payers Generally speaking, you are required to contract with the insurance companies in order to do business. In addition, some companies will require Joint Commission or CHAPS accreditation to be a contracted provider. Although you may be eligible to contract with the insurance companies, that does not mean that the insurance companies have to admit you to their network. Many times, admission is determined by specialty, regional need and demand. If you offer special services that may set you apart from other Home Health or Hospice agencies, be sure to let them know!

I Am a Contracted Provider. Now What? There are a number of differences between handling Medicare and commercial care. It is imperative that your staff is trained on what is needed to take on patients with private insurance. While most Home Health & Hospice agencies have a certain comfort level with Medicare processes, it is much more variable in commercial care. Each insurance company requires different details for authorization and reimbursement. Being knowledgeable in these details will make a big difference in ensuring that your agency is accurately paid for the services that you delivered.

Authorizations Most insurance companies require pre-approved authorizations for care. Authorizations should be acquired before you see any patient. Seeing a patient without prior authorization could lead to non-covered services.

Authorizations usually cover a set period of time and a certain number of visits. Your agency must keep track of this information. If your patient will require more services, you must contact the company for further authorization, and provide justification in writing for the additional services. If you go beyond your authorized dates or provide more visits than authorized, be prepared for those services to be non-reimbursable. This can be an adjustment for field nurses that are accustomed to adding PRN visits for Medicare patients.

Electronic Billing Paper claims can be a nightmare. They can easily get lost and can be difficult for your agency and the insurance company to keep track of. As a result, most private payers require or, at a minimum, prefer electronic billing. Some offices have as many as 64 different payers that have to be set up to be billed correctly. Typically, each one will require an NPI number, tax ID number, etc. In addition, many commercial payers do not pay episodically. Visits and services are individually authorized and billed. More often than not, co-pays and/or deductibles are required. Given these challenges, it is important that you have knowledgeable commercial billers to handle your commercial claims. Billers with Medicare experience won’t necessarily get the results your agency is looking for.

Follow-Up is Critical Most agencies are accustomed to following up on Medicare claims. It’s a pretty straightforward process. However, it’s not so simple with commercial insurance companies. Every payer has its own set of rules and your agency is responsible for knowing and ensuring that you follow them. Follow-up is critical in order to keep positive cash flow for your agency. However, this can be very time consuming when dealing with several companies. Effective follow-up requires billers who are well trained and familiar with each step of the process. Due to the complexity of the billing process for commercial and managed care companies, most agencies choose to electronically bill through third party vendors or “clearinghouses.” These companies can help your agency stay on top of the regulations and setup required by each payer, providing the necessary claim follow-up and on-going coordination as needed.

Home Care Software Purchasing Checklist

It is important to choose a Home Care software or Hospice software vendor who is right for your business. The software you select should help your agency streamline operations, accelerate reimbursement and improve patient outcomes.
We sincerely hope you find the list helpful in your software selection process and that we will have the opportunity to earn your business.

Return on Investment
Security & Compliance
Marketing Advantage
Focus on Patients, Not Paperwork

Hospice Software Purchasing Checklist

It is important to choose a hospice software vendor that is right for your business. The software you select should help your agency streamline operations, accelerate reimbursement and improve quality of care.

Return on Investment
Security & Compliance
Marketing Advantage Focus on Patients, Not Paperwork