Struggling to figure out how to correctly work out mileage reimbursements for your home health patients? This article will help! Learn how to accurately work out the mileage reimbursement rate and keep track of patient visits without hassle. Become a Mileage Master with these awesome tips and tricks!
Mileage calculation is a must for home health services. Knowing how to figure out and record miles correctly helps patients get the right payment for their medical visits, and provides proof of care.
Mileage is calculated using the shortest route between the start and destination points. This includes the patient’s location, therapist visits, and physician, lab or pharmacy appointments. To get accurate mileage for home health patient medical visits, you can use a map or GPS.
Only driving mileage is reimbursable when needed to provide home health care based on insurance company guidelines, doctor orders and payer requirements. If a therapist travels to a special location for a multi-system disorder visit, per CMS Home Health Agency Conditions of Participation, reimbursement may be available if all criteria are met before the journey.
Understanding Reimbursement Rates for Home Health Patients
Home health care services are offered to patients in their homes. This eliminates the need for frequent doctor and hospital visits. Home health agencies must understand their reimbursement rates from Medicare and insurers.
As well as service costs, agencies must also calculate mileage reimbursements at a rate per mile traveled. Medicare and other third-party payers have strict requirements for these charges.
Therefore, it is important for billing staff and/or administrators of home health agencies to understand reimbursements to correctly bill third-party payers and receive full payment or reimbursement.
Mileage Reimbursement Requirements:
- Local state laws must be followed to document miles traveled each day
- Records must be signed by both parties involved (agency staff & patient(s))
- Check reimbursements meet identified guidelines set by Medicare or third-party payers
- Follow predefined ratios according to vehicle type
- Calculate the total amount due using the most direct route from the patient’s residence to agency office.
Calculating Mileage for Home Health Patients
Figuring the number of miles driven for home health services can be tricky. It is important to know the rules and regulations around these types of reimbursements. The process can be different in different states and regions, so you should know the specific rules in your area.
When calculating driving mileage for home health visits, you must note the source of payment (i.e. Medicare, private insurance, or out-of-pocket). Also, there are other factors to consider when calculating mileage reimbursement.
Mileage Rates: Healthcare providers usually use the IRS standard mileage rate as a guideline. This rate changes yearly, so it is important to keep up with any adjustments to calculate the correct reimbursement rate.
Driving Paths: When calculating total mileage for home health visits, the driving route must be taken into account. Depending on the state and region, there could be different requirements for a valid ‘mileage qualified’ route. For instance, some regions may not allow visits that require detours from the normal travel route.
Overnight Stays: If a home health care professional must stay overnight, due to weather or distance, these additional lodging expenses must be included in their total mileage reimbursement rate.
By taking time to review the rules regarding calculating mileage reimbursement rates, drivers can meet government standards and maximize their reimbursements.
Common Mileage Calculation Mistakes to Avoid
Reimbursing patients for their home health miles is a complex job. It can be tricky to get it right, so here are some mistakes to watch out for!
- Not looking at all routes. Consider every way to get to the patient’s place. Include any extra stops and detours for medical appointments or errands.
- Forgetting tolls and ferries. If the patient lives in an area with these, remember to add them to the cost.
- Missing out on parking fees. These need to be included in the total.
- Miscalculating miles. Use up-to-date mapping tech to be exact.
- Not adjusting for inflation. Take into account current gas prices and inflation when submitting claims. This will help you stay accurate and compliant.
Tips for Improving Mileage Calculation Accuracy
Accurate mileage calculations for home health patients are crucial for fair care provider compensation. Here are some tips to measure medically related travel:
- Start and stop odometer readings should be taken within the same radius, at least 1 mile away from the service site.
- Account for road conditions, and construction that may add extra travel time.
- For local roads not on standard maps, use street maps or directions.
- If no GPS device, ruler, or measuring tape can map out the route.
- When calculating round trips, double each way and add.
- For urban areas over 100 miles apart, consider airlines or public transport when applicable.
- Always keep detailed records of mileage expense calculations in case of Medicare review or audit.
Benefits of Accurate Mileage Calculation for Home Health Patients
Accurate mileage calculation is vital when taking home health patients to appointments and errands. This affects the quality of care they receive. Knowing the benefits of accurate mileage calculation helps caregivers make wise decisions about distance traveled and transportation costs.
Accurate mileage records let home health agencies bill for exact expenses. This helps them decrease costs and increase their bottom line. It also reduces the chances of overcharging or wrongly claiming non-covered expenses. Records also show potential staffing ratios compared to those in annual budget plans, so providers can plan for future changes. Plus, they prove that quality healthcare was provided, with access to resources during transit and no liabilities from utility expenses.
Accurate mileage readings make sure patients get the services they need during transport, and avoid stressful situations caused by expenses. Caregivers should know essential routes and may need to do a route assessment. This involves:
- Landmarks
- Pictures
- Maps for sudden reroutes
- Traffic that increases driving time
Resources for Home Health Mileage Calculation
To calculate mileage reimbursement for home health patients, there are several resources available. This must be compliant with Federal Medicare/Medicaid guidelines for timely and accurate payment of reasonable expenses. Home health services may involve travel, medical supplies, equipment, and drugs. To report this accurately, you can use the shortest practical route, GSA rate or Medicaid rate. Resources include maps, GPS devices, and web-based programs.
GSA rate is updated annually based on fuel costs in each state. It’s published in a monthly GSA Bulletin, available on the US Office of Personnel Management website or the General Services Administration website. In 2020, it’s $0.585 per mile for personal cars.
Medicaid rate should be used when providing service in states with no rate. This doesn’t apply if you choose a more cost-effective route than USDA’s standard rural distance tables. You can use mapping tools like Google Maps or MapQuest.
Technology can help track and document quarterly mileages reported with specific services. This includes paper logs, web-based programs like HHM, GPS devices like Gaia GPS, and internet applications like Google Maps Mileage Calculator. All must be HIPAA compliant for patient security. This applies to data transit via internet browsers when documenting mileage reimbursements for services received by patients, with previous authorization from CMS.
Conclusion
Accurately calculating patient mileage is essential for quality home health care. Home health providers can manage their reimbursement costs and payers receive their correct balance with precise calculations. Patients also benefit from accurate calculations of their mileage, aiding them in getting the best care.
Understanding reimbursement rates by state and type of travel helps providers make sound decisions on payment collection, benefiting both provider and patient. Providers should consider factors such as gas prices, inflation, and patient-required distances when calculating mileage. Utilizing these methods ensures healthcare professionals understand FDA regulations and provide the best care while maximizing revenue potential.
