Discussion Guide: Advanced Coding and Billing-Advanced Coding and Billing Discussion Guide

Advanced Coding and Billing Discussion Guide

Pdf Summary

The "Advanced Coding and Billing – Discussion Guide with Facilitator Notes" by the Home Centered Care Institute is designed to help leaders conduct discussions with home-based primary care (HBPC) providers who have completed an online course on advanced coding and billing for house calls. This guide aims to help these providers maximize their coding opportunities to increase fee-for-service revenue. The discussions should last around an hour and involve various learning points regarding regulatory compliance and the implementation of specific codes and services.<br /><br />The target audience includes learners who have completed the mentioned online education activity. The materials required for the discussion include hard copies of the Next Steps handout, and optionally, handouts or flipcharts explaining key services such as Transitional Care Management (TCM), Chronic Care Management (CCM), Advance Care Planning (ACP), and Prolonged Services.<br /><br />The agenda outlines the topics and time allotment as follows:<br />1. Introduction (5 minutes)<br />2. Transitional Care Management (10 minutes)<br />3. Chronic Care Management (10 minutes)<br />4. Advance Care Planning (5 minutes)<br />5. Prolonged Services (5 minutes)<br />6. Debrief (5 minutes)<br /><br />Discussion questions prompt participants to reflect on the complexities and necessities of accurate coding in HBPC compared to other settings and explore each service area in detail. For TCM, discussions revolve around definitions, typical patient scenarios, advantages and challenges, and specific requirements such as interactive contact and non-face-to-face services. Topics for CCM include identifying qualifying chronic conditions, the benefits to patients, and the logistical requirements for billing. ACP discussions focus on understanding the differences from advance directives, its importance, and strategies to engage patients and caregivers in these discussions.<br /><br />The guide also addresses prolonged services, including billing specifics and the integration of these coding opportunities into the practice's billing model.<br /><br />In the debriefing session, participants are encouraged to review the "Next Steps" handout, commit to subsequent actions, and share implementation ideas. This comprehensive guide aims to enhance providers' proficiency in advanced billing and coding, thereby optimizing practice revenue and patient care efficiency.

Keywords

Advanced Coding

Billing

Home-Based Primary Care

Discussion Guide

Regulatory Compliance

Transitional Care Management

Chronic Care Management

Advance Care Planning

Prolonged Services

Revenue Optimization