PDGM Keys to Success - Circle with hourglass and key in the center

Counting Down to PDGM

Do you know how to solve the PDGM puzzle for your organization?

You’re locked in a race to meet CMS’ home health Patient-Driven Groupings Model (PDGM) rules. You can run, you can try to hide, but there’s no panic button you can hit to escape PDGM.

The countdown to January 1, 2020, is on. PDGM is coming for your home health care organization, and it’s up to you to crack the codes, solve the puzzle, and get out with your operations and revenue intact.

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PDGM may be the most significant payment change for the home health industry since 1997. The new rules are expected to drastically change home health reimbursement when they take effect next year. To succeed under PDGM, home health organizations need to start now, by assessing and scrutinizing every corner of their operations, from intake to care management to coding and billing.

Through teamwork, you can solve the PDGM puzzle for your organization. With eSolutions on your team, you can crack the codes, breakout and win the PDGM game with plenty of time to spare. We can help you ensure that you have the right revenue cycle management processes in place and maximize your reimbursements now, setting your organization up for success in the new PDGM world.

Webinar: PDGM Billing Dynamics

December 13, 2019 @ 11:00 a.m. – 12:30 p.m. (CST)

This webinar will cover all the intricate details of billing RAPs and Final Claims under PDGM beginning January 1, 2020. We will discuss the necessities of eligibility verification, orders management and will outline the specific criteria for billing RAPs and Final Claims. The reimbursement percentages and the impact on cash flow will also be detailed. The Notice of Admission (NOA) that will replace RAPs will now begin in 2022, but the requirement to file a No Pay RAP will still be in place in 2021. Join us and make sure that your billing staff is on top of these critical billing dynamics. This is an imperative webinar for starting out the new year right!

PDGM Webinar Series

eSolutions, the Medicare billing experts, has joined forces with Karri Wright, Sr. Director of Product Management at Homecare Homebase, to bring you a special webinar series sure to deliver the insights you need to prepare your home health agency for PDGM.

Stay Tuned to eSolutions’ Blog for the Latest on PDGM

You may feel a little frazzled or confused by PDGM and the changes it will bring starting in 2020, but don’t hit the panic button. Our PDGM blog series has the latest info on how to stay ahead of the game.

Learn More About PDGM

To find out more about PDGM, the Centers for Medicare & Medicaid Services (CMS) offers a wealth of resources online.

Visit the CMS Home Health Agency Center to get started.

Also available is a white paper that offers an in-depth explanation of PDGM and the changes it will bring for home health agencies.

Stay up to date on PDGM happenings by visiting the National Association for Home Care & Hospice PDGM Education page.

PDGM Quick FAQs

Want to learn more about this new payment model? Read through out Quick FAQs.

PDGM Preparation Tips

If you haven’t yet begun preparing for PDGM, don’t panic. Take a look at our PDGM Preparation Tips.

PDGM Intake Tips

Intake is one of the first steps of the reimbursement process and PDGM is going to make it even more hectic. Check out our PDGM Intake Tip Sheet here.

PDGM Behavioral Adjustments FAQs

What are behavioral adjustments and how will they affect your agency? Find out in our Behavioral Adjustments FAQs.

Set yourself up for PDGM success by connecting with us today!