Homecare Clinical Specialist - Oasis (HCS-O)
This is a certification in medical coding for Home Health care nurses responsible for completing OASIS Admission/Resumption of care assessments required by Medicare provided by the Board of Medical Specialty Coding and Compliance. It has nothing to do with masters prepared Clinical Nurse Specialist education.
Medicare-certified home health agencies are required to use a standard set of data items, known as OASIS (Outcome and Assessment Information Set) as part of a comprehensive assessment for all patients who are receiving skilled care that is reimbursed by Medicare or Medicaid. OASIS data are submitted by home health agencies to the States 30 days post admission, and subsequently transmitted to the Centers for Medicare & Medicaid Services. These data form the basis for patient case mix profile reports and patient outcome reports that are used by home health agencies for quality improvement and quality monitoring purposes and by state survey staff in the certification process.
Under prospective payment, Medicare pays home health agencies (HHAs) a predetermined base payment for a 60-day episode of care. The payment is adjusted for the health condition and care needs of the beneficiary. The adjustment for the health condition, or clinical characteristics, and service needs (SN, PT, OT, ST, HHA) of the beneficiary is referred to as the case-mix adjustment -- based on patients functional status and how accurately this is documented on the OASIS documentation submitted to Medicare.
My employer requires all Utilization Review RN's who prioritize and code diagnosis based on how clinicians answer the OASIS questions to obtain this certification as it helps to minimize underpayments and accuracy of data submitted. With any review finding inaccurate/incomplete information, they contact staff who performed assessment and discuss inaccuracies/missed items etc.
Moving this to our Home Health Nursing