We like to think of homecare compliance as the dough of a delicious slice of pizza. You need a strong sturdy crust before you can even think about adding sauce and cheese, let alone the toppings that are known to elevate a great slice. If your agency isn’t in compliance with federal and state regulations, then you aren’t going to be able to provide services or grow your business. You’ll simply have a saucy, cheesy mess. Learn how HHAeXchange’s solution helps providers maintain caregiver, HR, EVV, HIPAA, and billing compliance.
Being compliant begins before a client visit even takes place. There are multiple caregiver compliance requirements including, onboarding and training requirements, medical compliance requirements (i.e., making sure caregivers have all their vaccines), HR requirements like I-9 forms and criminal background checks, and exclusion list compliance. HHAeXchange can help streamline these caregiver compliance requirements with the following features:
The Office of Inspector General (OIG), as well as state agencies, create lists of individuals that cannot be hired for federally funded healthcare programs. Providers need to check that their caregivers aren’t on these exclusion lists (think of them as “no-fly” lists but for healthcare), otherwise they may be penalized. HHAeXchange makes it easy for providers to perform these checks for all their caregivers at once, eliminating the need for manual, individual checks. Agencies can also automate these to occur at predetermined intervals, such as monthly, allowing them to remain compliant without needing constant manual oversight.
HHAeXchange’s electronic storage capabilities offer a significant advantage. Agencies can securely store and manage vital documents like caregiver certifications, client records, and compliance documents within the system. This digital approach not only saves physical space but also improves data retrieval efficiency, provides an audit trail, and ensures better privacy and security in line with HIPAA standards.
For caregiver-specific compliance, the platform provides tools for monitoring requirements and deadlines. Notifications and alerts can be set up to remind both administrators and caregivers of upcoming compliance-related tasks, ensuring nothing is overlooked.
The 21st Century Cures Act mandated that states implement Electronic Visit Verification (EVV) for all Medicaid personal care services and home health services that require an in-home visit by a provider. EVV is the process of using electronic means like interactive voice response (IVR), FOB devices, or GPS-enabled mobile apps to verify that care has been delivered for these services. Agencies use EVV to remain compliant with federal requirements, and as an effective tool to track caregiver arrivals and departures, ensuring clients get the care they need, when they need it. If providers want to avoid penalties, then they must be EVV compliant.
Outside of offering the tools necessary for homecare agencies to capture EVV data (such as the mobile app, FOB devices, and IVR), HHAeXchange also has several features that make it easy for providers to monitor and improve their EVV compliance percentage.
Agencies can generate comprehensive reports that not only show their overall EVV compliance rates but also provide granular data, such as the verification method used for each visit. They can even filter it to show compliance at an individual payer, caregiver, or client level. This level of detail helps agencies identify specific areas where compliance might be lagging and implement targeted improvements.
HHAeXchange’s Call Dashboard is a critical tool for day-to-day management of caregiver activities. It offers real-time insights into caregiver check-ins and check-outs, allowing agencies to quickly address any discrepancies or issues. The ability to manually edit visit records ensures that all data reflects the actual care provided, an essential factor in keeping accurate and compliant records.
HHAeXchange takes HIPAA compliance seriously, as shown by its gold standard achievement in compliance. In 2018, HHAeXchange was among the first homecare software platforms to earn HITRUST CSF status.
The platform allows for customized role-based access to sensitive information, ensuring that each staff member only sees the data relevant to their role. This protects patient privacy and minimizes the risk of data breaches.
One of the ways homecare agencies may accidentally slip-up on HIPAA compliance is by texting back and forth with their caregivers about clients. That’s where the mobile app’s compliance with HIPAA standards becomes a great asset. The mobile app’s two-way chat system allows for secure communication between caregivers and the agency. This ensures that all exchanges of health information are conducted within a protected environment, safeguarding patient confidentiality.
Submitting compliant claims is how you guarantee that your agency gets paid on time. That’s why it’s so important that your claims have all the requirements to be invoiced and that your invoice has all the correct information before being sent to the payer. HHAeXchange offers comprehensive tools to ensure this happens.
Our pre-billing functionality allows agencies to verify that all invoicing requirements are met before billing processes begin. This preliminary step reduces errors and rejections from payers, and helps providers achieve the 99.9% first-pass acceptance rate that we are so proud of here at HHAeXchange.
So, how does it work? As soon as a caregiver clocks in and clocks out with EVV, that data appears in HHAeXchange, allowing schedulers to manage any exceptions, like missed or late visits. After these exceptions are cleared, HHAeXchange’s pre-billing function will automatically verify that the visit matched the contract, authorization, and plan of care. Once this pre-billing process is complete, providers can perform a final billing review to resolve any remaining contractual issues with the visits.
The platform can also manage complex billing scenarios, such as split shifts. The Overnight Shift Split feature automatically splits overnight shifts into two visits when a caregiver is working an hourly shift that goes through the night and into the next morning.
Users have the autonomy to split shifts if they run more than five minutes into a new day. Once enabled, a caregiver will only need to clock in and out once for overnight shifts. EVV information is copied to both visits, including any duties performed, patient signature, etc.
Compliance may not be the most exciting part of running a homecare agency, but if you want to provide high quality care to your clients, then it’s something you need to master. Let HHAeXchange help you build a strong base for your agency’s success — learn more and get started today!
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