There are many different certifications in home health. Many are very similar certifications, but often through a different company. For home health QA, there are really mainly three areas of expertise for QA in home health. They are certifications in diagnosis coding, OASIS, and compliance. These certifications are available through different companies. HCS-O stands for Home Care Clinical Specialist- OASIS. This is a usually a nurse, physical therapist, or occupational therapist that is familiar with home health and OASIS first.
Many people believe that medical coding is medical coding. Home health coding is very specialized and requires more than just transcribing records into code form. There are coding rules, exceptions, assumed relationships, and little things that take a lot of time and skill to learn. In addition to coding, OASIS review is equally important to show the complete and most accurate picture of the patient at the time of assessment.
The information in the OASIS is used to determine many things, including policies considered by CMS, outcome data such as 5 Star ratings, reimbursement rates, and other key metrics. It is essential to get OASIS correct. This gives the most accurate and correct snapshot of the condition of the patient at the time of assessment.
Not only is important to get OASIS correct, as many field clinicians don't understand OASIS or the need for it, there are a lot of rules and regulations about OASIS. It is a complex assessment and requires knowledge and clinical judgement. It really is important to have both coding and OASIS certifications so that OASIS is correct.
Many agencies and reviewers talk about financial gain per chart. That is important. More important, however, is that OASIS and coding are correct. We want these correct, and when they are correct, dollars follow, positive outcomes are recorded, and the patient gets the best care because the reimbursement was correct for the needs of the patient.
Here is a link for a great study guide to become OASIS certified.