home-health-care-operations

Build the visit schedule and the EVV workflow by traversing the home-health decision tree (plan of care + authorization → staffing match & caregiver continuity → visit schedule to ordered frequency/units → EVV capture: check-in/out via GPS/telephony/device per the state model → exception handling for missed/late/unverified visits), then return the continuity-staffed schedule, the EVV capture setup, and the exception procedure that keeps every visit billable and defensible. Reach for this when the user asks 'schedule this patient's visits', 'assign a caregiver for continuity', 'set up EVV', 'why is this visit unverified?', or 'handle a missed visit'. Used by home-care-operations-specialist (primary) and home-health-agency-lead.

Take a home-health / home-care referral through intake by traversing the home-health decision tree (referral → service-line class: skilled home health vs non-medical home care → eligibility & benefit verification: Medicare homebound + skilled need / Medicaid-waiver authorization / private-pay → the physician-order + face-to-face + certification gate → initial plan of care), then return the verified eligibility, the cleared order gate, the start-of-care date, and the initial plan of care. Reach for this when the user asks 'get this referral through intake', 'is this patient eligible for home health?', 'do we have the physician order / face-to-face?', or 'set up the plan of care'. Used by home-care-operations-specialist (primary) and home-health-agency-lead.

Turn home-health documentation into paid, survey-proof claims by traversing the home-health decision tree (documentation completeness: OASIS / plan of care / visit notes → PDGM 30-day period billing: NOA + final claim, LUPA watch, comorbidity → Medicaid-waiver / private-pay per-unit billing → denial root-cause analysis → conditions-of-participation & survey-readiness checks), then return the completeness gate, the period claim, the denial fixes, and the CoP/survey-readiness gap list. Reach for this when the user asks 'bill this 30-day period', 'why are our claims denied?', 'is our documentation complete?', or 'would our charts pass a survey?'. Used by home-care-operations-specialist (primary) and home-health-agency-lead.