AHCC Talk

Association of Home Care Coding and Compliance

Join advisory board members from the Association of Home Care Coding & Compliance for a monthly update on diagnosis coding, OASIS and HOPE assessment data collection, and the documentation issues that matter most in home health and hospice. https://ahcc.decisionhealth.com/

  1. 20h ago

    Coding & OASIS: How Small Decisions Affect Reimbursement

    On this episode of AHCC Talk, Christine Mickel joins Jan Milliman to examine the connection between physician documentation, clinical assessment, coding, OASIS responses, and reimbursement under PDGM. Learn how clinical grouping is established, when comorbidities may affect payment, why the same functional score can produce different results, and what to reassess at recertification. Plus, work through the latest AHCC scenario spotlights involving hospice symptom follow-up requirements and proposed CY 2027 PDGM changes. ✅ Jan Milliman, HCS-D, Director, AHCC ✅ Christine Mickel, PTA, HCS-D, HCS-O, HCS-H, Manager, OASIS and Coding, McBee Associates Links Mentioned in the Episode 2026 Home Health Payment & Compliance Virtual Summit: https://store.decisionhealth.com/hh-payment-compliance Calendar Year 2027 Home Health Prospective Payment System (HH PPS) Rate Update: https://www.federalregister.gov/documents/2026/07/06/2026-13602/calendar-year-2027-home-health-prospective-payment-system-hh-pps-rate-update-requirements-for-the-hh Learn more about AHCC credentials: https://store.decisionhealth.com/ahcc-credentials ⬇️ Downloadable slides from this discussion: https://ahcc.decisionhealth.com/media/1795/ahcc-talk-episode-93-handouts-final.pdf 📧Have a question, episode request, or suggestions for a future panel guest? Email Jan at jan.milliman@decisionhealth.com

  2. Jun 17

    HOPE After Eight Months: Workflow, Timing, and Submission Lessons

    On this episode of AHCC Talk, Jan Milliman, HCS-D, Director of AHCC, is joined by AHCC Advisory Board member Lisa Selman-Holman, JD, BSN, RN, HCS-D, HCS-H, HCS-O, COS-C, Vice President of Clinical Services with McBee, for a look back at the first eight months of using the Hospice Outcomes and Patient Evaluation — HOPE — tool. Jan and Lisa discuss how the transition from HIS to HOPE has affected hospice workflows, documentation, visit timing, symptom follow-up visits, data integrity, and compliance risk. They also review common submission issues, rejection patterns, warning vs. error distinctions, and practical ways teams can improve acceptance rates and HOPE accuracy.✅ Jan Milliman, HCS-D, Director, AHCC✅ Lisa Selman-Holman, JD, BSN, RN, HCS-D, HCS-H, HCS-O, COS-C, Vice President of Clinical Services, McBee Links Mentioned in the Episode Medicare Program; FY2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements: https://www.federalregister.gov/documents/2026/04/06/2026-06604/medicare-program-fy-2027-hospice-wage-index-and-payment-rate-update-and-hospice-quality-reporting Hospice Outcomes and Patient Evaluation (HOPE) Guidance Manual v1.01: https://www.cms.gov/files/document/hope-guidance-manual-v1-01.pdf Hospice Quality Reporting Program: https://www.cms.gov/medicare/quality/hospice Learn more about AHCC credentials: https://store.decisionhealth.com/ahcc-credentials ⬇️ Downloadable slides from this discussion: https://ahcc.decisionhealth.com/ahcc-talk-episode-92-eight-months-of-the-hospice-hope-tool/ 📧Have a question, episode request, or suggestionsfor a future panel guest? Email Jan at jan.milliman@decisionhealth.com

  3. May 13

    Survey Readiness: Top Home Health Deficiencies to Watch in 2026

    In this episode of AHCC Talk, host Jan Milliman, HCS-D, is joined by J’non Griffin, RN, MHA, HCS-D, HCS-H, HCS-C, COS-C, Director at SimiTree Healthcare Consulting, for a timely discussion on survey readiness for home health agencies. Jan and J’non break down the most common deficiencies identified by CMS, CHAP, ACHC, and TJC, including recurring issues around individualized plans of care, patient communication, documentation reliability, medication regimen review, infection control, and aide supervision. Listeners will learn why the same standards continue to appear year after year, how agencies can identify workflow gaps before surveyors arrive, and what a practical 90-day survey readiness plan can look like. ✅ Jan Milliman, HCS-D, Director, AHCC ✅ J'non Griffin, RN, MHA, HCS-D, HCS-H, HCS-C,COS-C, Director, SimiTree Healthcare Consulting Links Mentioned in the Episode Reserve your spot at the Home Care Leadership Summit: decisionhealth.com/hcls2026 ⬇️ Downloadable slides from this discussion: https://ahcc.decisionhealth.com/media/1785/ahcc-talk-episode-91-handouts.pdf📧Have a question, episode request, or suggestionsfor a future panel guest? Email Jan at jan.milliman@decisionhealth.com

  4. Apr 28

    Complicated Coding Scenarios (and How to Solve Them)

    In this episode of AHCC Talk, host Jan Milliman is joined by coding experts Celeste Miller and Apryl Swafford to walk through real-world coding challenges that home health professionals face every day. From respiratory conditions and sepsis to trauma and complex post-surgical infections, this episode breaks down how to approach difficult scenarios with confidence—while staying aligned with official coding guidance. What you’ll learn: How to code COPD with exacerbation and concurrent conditionsKey considerations for sepsis with resolved acute conditionsDocumentation pitfalls in fracture codingHow to approach post-procedural infections and osteomyelitisClarifications on Face-to-Face requirementsWhat to do when a recertification OASIS is completed outside the allowed windowEach scenario is designed to sharpen your coding accuracy and help you apply guidelines to complex patient cases. ✅ Jan Milliman, HCS-D, Director, AHCC ✅ Celeste Miller, RN, BS, HCS-D, HCS-O, Executive Director of Quality Assurance, Aegis Healthcare ✅ Apryl Swafford, RN, BSN, COS-C, HCS-D, HCS-H, HCS-O, QA Manager, SimiTree Healthcare Consulting Linked Mentioned in the Episode Downloadable slides from this discussion: https://ahcc.decisionhealth.com/media/1783/ahcc-talk-episode-90-handouts.pdfLearn more about AHCC: https://ahcc.decisionhealth.com/?utm_source=spotify&utm_medium=podcast&utm_campaign=dhbmscahcc&utm_content=ahcc_talk_spotifyHome Care Leadership Summit (May 19–21, Orlando): https://store.decisionhealth.com/home-care-leadership-summit?utm_source=spotify&utm_medium=podcast&utm_campaign=hcls_2026&utm_content=ahcc_talk_spotify

  5. Mar 20

    Face-to-Face (F2F) in Home Health: Rules, Risks & Compliance Tips

    In this episode of AHCC Talk, we break down the face-to-face (F2F) requirement for home health—a critical condition of payment tied to compliance and reimbursement. Learn what qualifies as a valid encounter, who can perform it, and how to avoid the most common documentation mistakes that lead to denials. We also cover timing rules, telehealth updates through 2027, and practical strategies to ensure your agency stays compliant and audit-ready. Perfect for coders, clinicians, and compliance professionals navigating home health regulations.This episode's panel includes: ✅ Jan Milliman, HCS-D, Director, AHCC ✅ Lisa Selman-Holman, JD, BSN, RN, HCS-D, HCS-H,HCS-O, COS-C, Vice President of Clinical Services, McBee ✅ Lisa McClammy, BSN, RN, COS-C, HCS-D,HCS-O, Senior Clinical Education Consultant, MAC Legacy Links Mentioned in the Episode 🔗 § 424.22 Requirements for home health services. https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-424/subpart-B/section-424.22 🔗 A Rule by the Centers for Medicare & Medicaid Services on 12/02/2025: https://www.federalregister.gov/documents/2025/12/02/2025-21767/medicare-and-medicaid-programs-calendar-year-2026-home-health-prospective-payment-system-hh-pps-rate 🔗 Palmetto GBO: Home Health Face to Face Checklist: https://dominoapps.palmettogba.com/palmetto/providers.nsf/files/Home_Health_Face_to_Face_Checklist.pdf/$FILE/Home_Health_Face_to_Face_Checklist.pdf 🔗 Join us May 19-21 at the Home Care Leadership Summit in Orlando, FL: decisionhealth.com/hcls2026 🔗 Join us for the next live airing of AHCC Talk: https://attendee.gotowebinar.com/register/2224811617290518541?source=yt 🔗 Learn more about AHCC and how to become a member:store.decisionhealth.com/join-ahcc🔗 NEW BOOK: Home Health Guide to Crafting a Compliant Plan of Care, 1st Edition: ⁠https://store.decisionhealth.com/2026-plan-of-care-guide⁠ ⬇️ Downloadable slides from this discussion: https://ahcc.decisionhealth.com/media/1774/ahcc-talk-episode-89-handouts.pdf 📧Have a question, episode request, or suggestions for a future panel guest? Email Jan at jan.milliman@decisionhealth.com

  6. Feb 26

    Crafting a Compliant Plan of Care: Tips, Risks, and Examples

    In this episode of AHCC Talk, our expert panel discusses how to create and implement a compliant and individualized plan of care (POC).Learn how to: Meet Conditions of Participation requirementsDevelop meaningful goals and interventionsAvoid common plan of care audit risksIndividualize care plans for better outcomesApply real-world POC examplesThe discussion includes practical scenarios and guidance to help clinicians and agencies strengthen documentation and compliance. ✅ Jan Milliman, HCS-D, Director, AHCC ✅ Sherri Parson, RN,. HCS-D, HCS-O, COS-C, CEO,Infusion Health ✅J'non Griffin, RN, MHA, HCS-D, HCS-H,COS-C, Direction, SimiTree Healthcare Consulting Links Mentioned in the Episode  🔗 NEW BOOK: Home Health Guide to Crafting a Compliant Plan of Care, 1stEdition: https://store.decisionhealth.com/2026-plan-of-care-guide 🔗Home Health J1800/J1900 Errata: https://www.cms.gov/files/document/oasis-e1-guidance-manual-errata-fmi-items.pdf 🔗October 2025 CMS Quarterly OASIS Q&As: https://qtso.cms.gov/system/files/qtso/CMS_OAI_Qtr_4_2025_QAs_October_2025_508c.pdf 🔗Join us May 19-21 at the Home Care Leadership Summit in Orlando, FL: decisionhealth.com/hcls2026 🔗Join us for the next live airing of AHCC Talk on March 16 at 1pm EST: https://register.gotowebinar.com/#register/2224811617290518541?source=podcast 🔗 Learn more about AHCC and how to become a member:store.decisionhealth.com/join-ahcc   ⬇️ Downloadable slides from this discussion: https://ahcc.decisionhealth.com/media/1773/ahcc-talk-episode-88-handouts.pdf   📧Have a question, episode request, or suggestionsfor a future panel guest? Email Jan at jan.milliman@decisionhealth.com

  7. Jan 27

    Falls & the New FMI Outcome: What Changed and Why It Matters

    Falls are receiving greater scrutiny than ever before—and with the introduction of the new Falls with Major Injury (FMI) Outcome, accurate assessment, scoring, and documentation matter more than ever.  In this episode, our expert panel breaks down what’s changed, why it matters, and how clinicians and agencies should respond. From OIG findings and CMS definition updates to practical scoring tips for OASIS items J1800 and J1900, this discussion connects regulatory guidance to real-world clinical scenarios. You’ll also learn how the FMI outcome is calculated, how risk adjustment works, and why the new methodology tells a different story about falls data—plus how agencies can focus on prevention without over- or under-reporting. ✅ Jan Milliman, HCS-D, Director, AHCC ✅ Lisa Selman-Holman, JD, BSN, RN, HCS-D ✅ Kelly Kavanaugh, RN, HCS-D, HCS-O, HCS-H Links Mentioned inthe Episode  🔗 OASIS E1 Manual: https://www.cms.gov/files/document/draft-oasis-e1-manual-04-28-2024.pdf 🔗OASIS Quarterly Q&As October 2025:https://qtso.cms.gov/reference-and-manuals/oasis-quarterly-q 🔗OASIS Static Q&As: https://qtso.cms.gov/providers/home-health-agency-hha-providers/reference-manuals 🔗All OASIS materials can be found at: https://qtso.cms.gov/providers/home-health-agency-hha-providers/reference-manuals 🔗Home Health - Falls with Major InjuryRespecification: Technical Specification Report https://www.cms.gov/files/document/fmi-technical-specification-report-hh.pdf-0List of codes found in Appendix B and Appendix C 🔗Home Health J1800/J1900 Errata: https://www.cms.gov/files/document/oasis-e1-guidance-manual-errata-fmi-items.pdf 🔗Join us for the next live airing of AHCC Talk on February 23 at 1pm EST: https://register.gotowebinar.com/#register/2224811617290518541?source=podcast 🔗 Learn more about AHCC and how to become a member:store.decisionhealth.com/join-ahcc   ⬇️ Downloadable slides from this discussion: https://ahcc.decisionhealth.com/ahcc-talk-episode-87-updates-for-classifying-falls-in-home-health/   📧Have a question, episode request, or suggestionsfor a future panel guest? Email Jan at jan.milliman@decisionhealth.com

  8. 12/16/2025

    Medical Necessity at Recertification: Documentation Tips, Common Gaps, and Real-World Scenarios

    In this episode of AHCC Talk, we break down what Medicare expects when it comes to medical necessity at recertification — and where agencies most often fall short. Host Jan Milliman, HCS-D is joined by Lisa McClammy, BSN, RN, COS-C, HCS-D, HCS-O, Senior Clinical Education Consultant at MAC Legacy, to discuss: What documentation must show to justify continued skilled careKey elements that support recertification and homebound statusCommon documentation gaps that put agencies at riskPractical examples of when skilled services are — and are not — reasonable and necessaryHow progress to goals, functional status, and risk factors support complianceThis episode also features a Scenario Spotlight focused on OASIS M1033.1 - History of Falls, helping listeners apply guidance to real-world documentation decisions. Links Mentioned in the Episode 🔗 AHCC certification study guides: decisionhealth.com/studyguides 🔗 If you're an AHCC member, register for the AHCC Member's Call on January 28 at 1pm EST: https://register.gotowebinar.com/register/8915984221266150240 🔗 Learn more about AHCC and how to become a member:store.decisionhealth.com/join-ahcc ⬇️ Downloadable slides from this discussion: https://ahcc.decisionhealth.com/ahcc-talk-episode-86-medical-necessity-at-recert/   📧Have a question, episode request, or suggestionsfor a future panel guest? Email Jan at jan.milliman@decisionhealth.com

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Join advisory board members from the Association of Home Care Coding & Compliance for a monthly update on diagnosis coding, OASIS and HOPE assessment data collection, and the documentation issues that matter most in home health and hospice. https://ahcc.decisionhealth.com/

Information

  • Creator
    Association of Home Care Coding and Compliance
  • Years Active
    2023 - 2026
  • Episodes
    38
  • Rating
    Clean
  • Copyright
    © Association of Home Care Coding and Compliance
  • Show Website
    AHCC Talk