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The PDGM Modeling Tool enables Home Health Centre to predict the HIPPS (Health Insurance Prospective Payment System) code, case mix, LUPA (Low Utilization Payment Adjustment) threshold and estimated billable amount for a given patient. These metrics are important because they determine the level of payment that the Home Health Centre will receive from CMS for providing care to the patient.
By using this tool, Home Health Centre can accurately predict the payment rate and estimated revenue for a given patient, which helps them to better manage their resources and plan for future growth. The tool also enables them to optimize their care delivery by ensuring that they are providing the appropriate level of care to each patient while remaining financially sustainable.
43.pngIn order to generate the results, it is necessary to complete the following fields:
Claim date
Admission Source and Timing
Comorbidity Adjustment
Functional Impairment Level
Patient Information
Then click Generate to display the results.
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