FAQs
Home Health | TJC | CHAP | Pediatrics | Start Ups | DMECHAP
- If TJC/CHAP are surveying me, do I still need to put in for readiness to the State?
- Who do I need to tell if I change telephone numbers or address?
- How long before I can bill Medicare?
- How many patients does an Agency need for a Joint Commission/CHAP survey?
- What is a qualifying service to Medicare?
- What is the difference between contact and clock hours?
- How do I request a consulting visit from Compliance Review Services?
- How do I sign up for an in-house class at Compliance Review Services?
- Does Compliance Review Services help get patients for our agency?
- How much money do we have to have in order to get through the Initial Medicare Survey?
- Can we bill for the 10 patients? When can we bill Medicare and how long does it take after we have passed the Initial Survey?
- The first 10 patients'—do they all have to be Medicare Payor Source?
If TJC/CHAP are surveying me, do I still need to put in for readiness to the State?
[back to top]The state regulation requires a Home Health or Hospice facility notify of readiness for initial survey prior to an initial license becoming 6 months old. The requirement is the actual notification, not that the survey is performed at the 6 month mark. Readiness for survey is done by completing and submitting DADS form 2020. Failure to do so, even if you are waiting an accreditation survey may affect your license renewal process when the time comes to renew. Even though you are seeking accreditation or have accreditation you must always follow DADS regulations, without a license from the state you cannot operate a Home Health agency or Hospice facility in the State of Texas and without a license, accreditation becomes a mute point.
Who do I need to tell if I change telephone numbers or address?
[back to top]The state regulation requires an agency to notify DADS within five days after a change in the agency'’s telephone number or after a change in the agency'’s operating hours.
An Agency must notify DADS 30 days before relocating to a new address.
Joint Commission or CHAPS must be notified if an agency has accreditation/certification with one of them.
CMS must be notified if an agency has Medicare certification
How long before I can bill Medicare?
[back to top]After the initial certification survey by Joint Commission or CHAP, standards compliance is validated for relevance and consistency in interpretation. An Accreditation decision is effective from the day Joint Commission/CHAP approves the Plan of Correction submitted by agency (if the agency received deficiencies). Once accredited, CMS is notified and they make the final certification notification to the agency and provide the agency with a '“Provider Number'?which enables the agency to begin billing Medicare.
How many patients does an Agency need for a Joint Commission/CHAP survey?
[back to top]Number of patients required for survey:
The Joint Commission
The Joint Commission
http://www.jointcommission.org
One Renaissance Blvd.
Oakbrook Terrace, IL 60181
630-792-3007CHAP
Community Health Accreditation Program, Inc. (CHAP, Inc.)
1275 K Street, NW, Suite 800
Washington, DC 20005
202.862.3413
202.862.3419 fax
info@chapinc.org
www.chapinc.orgHome Health 10 served and 7 active
Home Health 10 served and 7 active Hospice - 5 serviced, 3 active at time of survey
Hospice - 5 serviced, 3 active at time of survey
What is a qualifying service to Medicare?
[back to top]Qualifying services to Medicare include services rendered by skilled nursing, physical therapy, speech language pathology or continuing occupational therapy, which meet coverage criteria and covered under the Medicare Home Health Benefit. Medicare requires that the agency provide at least one of the qualifying services directly through agency employees.
What is the difference between contact and clock hours?
[back to top]Contact hours are educational hours for professional people (RN's for example) that have been approved and are required by professional boards; Clock hours are educational hours that a non licensed /professional can attend, or are required to attend. Clock hours are a requirement of DADS as part of their pre appointment and annual ongoing education for a Home Health or Hospice Administrator and Alternate Administrator.
How do I request a consulting visit from Compliance Review Services?
[back to top]On compliance Review Services'?web site under the navigation bar located on the left side of the home page, click on '“scheduling'? Print the '“scheduling request form'? complete the form and return to the office via fax 832-237-2505. If necessary you may also contact the office directly to request a consulting visit. Please remember the scheduling of consultant visits is done 30 days in advance.
How do I sign up for an in-house class at Compliance Review Services?
[back to top]On Compliance Review Services'?web site under the navigation bar click on "Training Center" and review the classes available and how to sign up. If necessary you may also contact the office directly to sign up for an in-house class.
Does Compliance Review Services help get patients for our agency?
[back to top]Compliance Review Services does not help agencies obtain patients. The agency must do their own marketing and secure their own patients through contacts that they may have. A few recommendations as to where to market would be: Nursing Home Social Workers, Hospital Discharge Planners, Physician Offices, Clinics, and other Health Care Industries such as Assisted Living Facilities.
How much money do we have to have in order to get through the Initial Medicare Survey?
[back to top]Of course overhead and budgeting has many variable from agency to agency, such as rent, payroll, patients supplies and services. The "Initial Reserve Operating Funds" (IROF) in accordance with CMS requirements for Home Health agencies in Texas((not Hospice) can range from $40,000, in more rural areas to 100,000 in more populated regions depending on the CMS calculator. Without proof of the requester IROF funds availability CMS will not issue a provider number.IROF will be verified 4 times- 1st during the initial enrollment application process.2nd-Before Medicare provider number is issued 3rd-When the Medicare provider has been issued but before it has been set up for billing. 4-When the Medicare provider number has been set up for billing for 3 months.
Can we bill for the 10 patients? When can we bill Medicare and how long does it take after we have passed the Initial Survey?
[back to top]Once officially accredited with Deemed Status, with an official accreditation date all active patients can then be given a new plan of care and re admitted after that official accreditation date for eventual Medicare billing. Medicare will issues a provider number only after receiving confirmation that deemed status accreditation has been awarded, and that the initial operating fund demands are met for the home health agency (not a hospice requirement) This process can take up to 3 months after survey by CMS and Palmetto GBA. Services to those active patients can be billed from their new start of care date forward once provider number is activated. The accreditation / Medicare survey itself does not mean an agency can begin to bill.
The first 10 patients'?do they all have to be Medicare Payor Source?
[back to top]The first 10 patients can be of any payor source. They may not have insurance or Medicare, they could be indigent patients. As long as the patients meet the Medicare criteria and eligibility outlined in Palmetto'’s guidelines, they can be admitted for the initial survey.
