Accurate, timely OASIS coding + QA

With a 24-hour turnaround, we expedite the journey from patient care to billing and reimbursement. Our comprehensive QA process includes:

Accurate Coding: Precise coding means fewer payor rejections, improved quality Star Ratings, and audit readiness for your agency.

Comprehensive Review: We review Start of Care (SOC), Resumption of Care (ROC), Recertifications (RCT), diagnosis codes, and perform a thorough OASIS review for quality, consistency, and opportunities for improvement.

Collaborative Approach: Our team works closely with your clinical staff to make necessary edits for a clean, compliant submission to payors.



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How we optimize cash-flow and revenue

Documentation and compliance errors can be costly, leading to delayed payments or claw-backs in the PDGM payment model for Medicare, FFS for Medicare Advantage, Medicaid, and Commercial Insurers. The HHVBP model adds further complexities.Hoolime ensures accurate and compliant OASIS documentation, enabling timely claim submission and payment. This reduces delays and the time spent on rejections, which can be costly when handled by internal staff who may lack specialized expertise.



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We integrate with your EMR and internal processes seamlessly

We integrate with your existing EMR (e.g., WellSky Home Health/Kinnser, Homecare Homebase, or others) and your agency practices. After clinicians submit their OASIS draft, our QA team reviews the referral package, seeks clarifications, and makes corrections before sending the chart back for clinician approval and submission to the Internet Quality Improvement and Evaluation System (iQIES).We provide weekly and monthly summaries with clinician-specific feedback to address recurring mistakes. Hoolime is HIPAA-compliant, using encrypted and authenticated communications and patient data storage methods to ensure information security and confidentiality.



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Plans for every need

Starter

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  • SoC OASIS review & recommendations
  • Share the accurate ICD-10 codes from the physician note, discharge summary, and clinician narrative.

Basic

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  • Everything in Starter +
  • Star rating focus - OASIS (admission, transfer, and discharge) review for inconsistencies focusing on parts that impact star ratings

Intermediate

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  • Everything in Basic +
  • In-depth review of section G of OASIS forms.

Advanced

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  • Everything in Intermediate
  • + Build Plan of Care (POC) and audit CMS 485
  • Pre-billing review to reduce claims rejections

More Add-Ons

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  • Audit-readiness including mock-audits to review accuracy and completeness of patient medical charts in compliance with regulatory requirements
  • Audio capture of clinician's narrative for additional efficiency and accuracy
  • Orders management
  • Clinician education and learning
  • Clinical pathways (plan of care development, frequency of visits, discharge vs. recertification) based on patient's diagnosis and condition