Medicare Accreditation for Home Heatlh Care Agencies

Open your home health care agency and acheive Medicare Accreditation to bill Medicare and Medicaid. 

Certified Homecare Consulting

Why Home Health Care Accreditation?

You have already made the wise decision to open a home health care agency. To take that decision to the next level, consider home health care accreditation. Becoming an accredited home health care agency is beneficial to your new home health care agency as it confers a sense of trust in your home health care agency to your referral sources. Doctors and Discharge Planners recognize that by having accreditation, your home health care agency is likely to provide the best care to their patients. It raises your profile and sets your home health care agency apart! Most insurance companies will not contract with home health care agencies unless they are accredited.

Certified Homecare Consulting has been accrediting home health care agencies for many years and understands exactly how to step through the accreditation standards process easily. Certified Homecare Consulting can help your home health care agency grow to that next level in a stable, planned, and experienced manner to capitalize on this growth opportunity.

About Certified Homecare Consulting

Certified Homecare Consulting are home health care consultants who help businesses and individuals start and manage their home care and home health care businesses. We currently own 4 home health care agencies, as well as other healthcare related businesses.
Certified Homecare Consulting are experts in developing pro forma budgets, writing licensure applications, and structuring your accreditation process to make the rigorous standards easy and understandable.

We guide you to successfully reach your goal of becoming a Medicare Certified Home Health Care Agency (CHHA).
Certified Homecare Consulting provides all the essential services to ensure the of your home health care agency:

• State Home Health Care Agency Licensure (where applicable)

• CLIA Waiver for Home Health Care

• Federal 855a application including templates for bank certification of required capitalization and client attestation letter

• CHAP Accreditation application, self-studies, and mock survey

• Clinical management

• Medicare PPS requirements

• Marketing Plan

• Contract analysis

• Recruitment Program (may be outsourced)

• Quality Improvement Program

• In-service Program (outsourcing recommended)

• Home Health Care Agency Software System (Kinnser recommended)

• Accounting system (QBP, Peachtree)

• Medical Advisor to attend biannual Professional Advisory Board Meetings required by Medicare Conditions of Participation

• Medicare Cost Report (outsourcing recommended)

• Strategic Planning to manage growth

Becoming a Medicare Accredited home health care agency requires commitment, resources (both human and financial) and perseverance. There is significant capital outlay required to go through your Medicare survey and receive the Medicare Provider approval. We are committed to NOT allowing you to fail. We work to ensure that your investment is not wasted by inexperience with the processes required to achieve success!

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    About The Home Health Care Industry

    As Medicare changed its processes from “fee for service” to prospective pay system (PPS) in 1999 many Medicare Accredited home health care agencies lost hundreds of thousands of dollars because they were not ready for the changing environment.

    While PPS is in effect, Medicare has already announced the future rollout of the newest evolution called “pay for performance”, and just as before, Home Health Care Agencies stand ready to lose hundreds of thousands of dollars again if they do not gain the expertise needed to steer away from the pitfalls.

    Certified Homecare Consulting has the industry breadth and current regulatory knowledge to assist our client companies avoid pitfalls. We constantly monitor and analyze the changing environment and are already preparing for the next Medicare adjustment to accommodate the staggering financial cost of the retiring baby boomer generation.

    It is the great baby boomer retirement phase that caused countless non-medical companies to decide to move to the next level to capitalize on the prosperity about to be unleashed and become Medicare Accredited Home Health Agencies. There is a current population of 40 million people aged 65 or older. This number is expected to grow to over 70 million by the year 2030.

    Certified Homecare Consulting can help your company grow to that next level in a stable, planned, and experienced manner to capitalize on this growth opportunity.

    Home Health Care Consulting and Medicare Accreditation | Frequently Asked Questions

    Q. Is this the right time to start ANY business?

    A. Absolutely! Although lending is difficult today, the bank bailouts have truly loosened up the lending market allowing for new lending to start again. Even if you have NO borrowing capacity, you can still start this business. However, lacking financial capacity, we recommend that you consider starting as a non-medical agency, stabilizing your new business and beginning to acquire revenues from these clients.

    Q. What are some of the financial requirements to get into this business?

    A. To become Medicare Accredited requires capitalization. The amount necessary for Medicare capitalization is dependent on the exact location where you will open your Home Health Care Agency. Capitalization requirements are higher in locations closer to major metropolitan areas. Capitalization fluctuates each year. Currently, capitalization is averaging between $83,000- $170,000. As a startup home health care agency, you are NOT required to spend any of this money; however, you must demonstrate you can fund your new Agency.

    Q. Is this the right time to grow your company to the next level?

    A. Absolutely! In a bad economy, unemployment goes up significantly. Private pay organizations are negatively affected by rising unemployment rates because many unemployed people are staying home to care for their family’s needs. In turn, this leads to private pay cutbacks and revenue loss, as a huge expense to your organization.

    Q. As an accredited homecare owner, what would my proceeds look like?

    A. In your Medicare Certified Home Health Care Agency, a single Medicare client is serviced for a 60-day (2 months) episode. The federal government pays 60% of the average $3000 they give for this client on the first billable visit! The remaining 40% is paid at the end of the episode when the discharge or new cert period is processed. The actual amount reimbursed is dependent on how your nurses answer the standardized OASIS assessment questions. The $3000 cited is an average not an actual amount. There are 6 (2 month) episodes in a year * $3000 = $18000. You can recover your entire consulting costs with just maintaining a client census of 3 throughout the year!

    The Medicare Accreditation Process for Home Health Care Agencies. We do it for you!
    1. Conduct your initial interview to determine your needs and collect your filing data
    2. Help you obtain Surety Bond, WC, General & professional liability policies for your agency if you don’t already have them
    3. Determine your Medicare Fiduciary Intermediary office and establish communication with the FI on your behalf
    4. Complete and submit your NPI application (National Provider Identification #)
    5. Prepare certification from Client Company’s Bank that funds are in the account and are immediately available for company use (Medicare Capitalization)
    6. Prepare attestation from Client Company that at least 50% of reserve operating funds are not borrowed
    7. Complete and submit your CMS855a Federal application
    8. Complete and submit your CMS588 Federal EFT authorization
    9. Complete and submit your CMS1561 Federal application
    10. Establish communication with the assigned State Regional Fiscal Intermediary
    11. Contact State Division of Licensure and Certification to apply for “deemed” status for Medicare Accreditation
    12. Help you process an OASIS test submission through DPH and/or CMS after the first certified client is admitted
    13. Complete & submit CMS116 CLIA waiver
    14. Complete & submit CORI application
    15. Complete & submit CHAP accreditation application
    16. Complete & submit accreditation self-study project (CORE and Home Health)
    17. Home Health Care Agency Policy & Procedure Manual development (11)
    18. Develop your Performance Improvement program and its 7 committees with manuals, minutes and trending forms for committee use
    19. Develop your Annual Agency Evaluation (required yearly)
    20. Customized Forms development
    21. Prepare a 36 month operating budget
    22. Determine EMR or manual Medical Record system
    23. Corporate Governance review: Legal Business Entity documents, Secretary of State filing, Articles of Incorporation (if S or C corp.), Management Agreements (if LLC), all Governing Board Minutes, Board of Directors approval of all policies (required by accreditation)
    24. Develop and implement Performance Improvement Program
    25. Conduct Pre survey site preparation
    26. Determine type of In-service Program to be implemented
    27. Annual Agency Evaluation format and training
    28. Medicare Cost Reporting (outsourced)
    29. Provide all training necessary to operate your new Medicare Accredited Agency via web-based training
    The Cost Of Medicare Accreditation for your Home Health Care Agency

    Certified Homecare Consulting charges a one-time fee the service of obtaining your Medicare Provider Accreditation as an accredited Home Health Care Agency through Community Health Accreditation Program (CHAP).

    This one-time payment can be broken down into smaller payments or put onto a payment schedule:

    A down payment is required to begin your process. This down payment includes:

    1. State specific licensure and regulatory submissions such as: CORI, NPI, Nurse Aide registry, CLIA, and any other state requirements needed
    2. Home Health Care Policies and Procedures (Personnel, Administrative, Clinical Procedures, Clinical Policies, Corporate, Finance, Company specific, MSDS, Sales, Contract, Surveyors Manual) & 7 Performance Improvement Committee manuals
    3. Hiring, visit, private pay and ancillary forms covering all disciplines and needs
    4. 36 month start up budget
    5. CHAP Accreditation application
    6. CMS 855a Approval
    7. Mock Survey

    Certified Homecare Consulting believes in not just getting our client’s Home Health Care Agencies Medicare Accredited but positioning them for success in the prosperous field of home health care. This is why Certified Homecare Consulting highly recommends outsourcing the following items while your home health care agency focuses on what is most important.

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