35+
Years of Expertise
1989
Serving Healthcare Since
U.S.
Based, Credentialed Staff
All
Facility Types Served

Overview

Accuracy Across Every Episode of Care

Under PDGM, home health reimbursement turns on the accuracy of the OASIS, diagnosis coding, and the documentation that supports each episode. The HIPPS code, visit disciplines, face-to-face certification, and plan of care all have to align — and small inconsistencies can mean denials, LUPAs, or compliance exposure.

HMI’s specialists perform comprehensive reviews of home health documentation to validate the billed HIPPS code, HCPCS codes for visit disciplines (SN, PT, OT, SW), units, diagnoses, and billable supplies — confirming the OASIS, plan of care, and face-to-face certification are complete and accurate against the final billed claim.

The Challenge

What Home Health Agencies Are Up Against

OASIS & Diagnosis Accuracy

Under PDGM, OASIS responses and diagnosis coding directly drive grouping and payment — accuracy is everything.

HIPPS & Visit Disciplines

The billed HIPPS code and visit disciplines (SN, PT, OT, SW) must be validated against the documentation and claim.

Face-to-Face & Plan of Care

Face-to-face certification and the plan of care must be complete and timely to support the episode.

Denial & LUPA Exposure

Documentation gaps lead to denials and low-utilization payment adjustments that erode margin.

We have been working with HMI since 2010 and the HMI coding staff is extremely knowledgeable and has become an integral part of our coding team. We appreciate the professionalism and teamwork we have with HMI.

Janet WillisDirector of Revenue Management · Monadnock Community Hospital

Frequently Asked Questions

Home Health Agencies, Answered

What does a home health claims review include?
Our specialists validate the billed HIPPS code, HCPCS codes for visit disciplines (SN, PT, OT, SW), units, diagnoses, and billable supplies, and review the OASIS, plan of care, and face-to-face certification for completeness against the final billed claim.
Do you understand PDGM?
Yes. Our reviews focus on the OASIS, diagnosis coding, and documentation accuracy that drive payment under the Patient-Driven Groupings Model.
Can you help reduce denials and LUPAs?
Yes. By confirming documentation, coding, and certification align with the billed episode, we help reduce the gaps that lead to denials and payment adjustments.
Are your coders credentialed and U.S.-based?
Yes. Every HMI specialist is 100% U.S.-based and holds industry credentials.

Accuracy Across Every Episode

Validate Every Episode
Before It’s Billed

Talk with HMI about home health claims review and coding support for your agency.