Sept 2016
Remembering Amedysis Founder William F. Borne 

Simione Healthcare Consultants mourns the tragic loss of Bill Borne, 58, of Baton Rouge, LA, on August 16.  The founder and former CEO of Amedysis, Bill started the national home health and hospice company in 1982 and led it to be one of most innovative and successful organizations in our industry. Bob Simione, Simione's Managing Principal, said, "Bill Borne was a gifted and dynamic leader with a level of drive and dedication that has propelled health care at home to a higher level of value and attention.  We are deeply saddened to hear of his passing, and send our heartfelt sympathy to his family, friends and the entire Amedysis family."  
Be Alert for CMS Enrollment Revalidation Reports  
The Centers for Medicare & Medicaid Services (CMS) Division of Enrollment Operations is beginning Cycle 2 of the provider and supplier revalidation process, as required under Section 6401 (a) of the Affordable Care Act. 
The Medicare Administrative Contractor (MAC) will send a revalidation notice within 2-3 months prior to the revalidation due date, either by email or regular mail.  Emails will be sent to email addresses reported on previous applications and will include "URGENT Medicare Provider Enrollment Revalidation Request" in the subject line.  Notices sent by mail will be sent to at least two of the reported addresses: correspondence, special payments, and/or the primary practice address.
Providers and suppliers should respond promptly to requests from their MAC.  If billing privileges are deactivated as a result of the provider or supplier's failure to respond to such request, reactivation will only be retroactive to the date of submission of a subsequently approved new enrollment application (not to the deactivation date), which will result in a gap in payment.  If deactivation occurs, the provider or supplier will maintain their original PTAN.
All providers should periodically review Medicare enrollment information on file.  Generally, changes are required to be made within ninety (90) days of the change.  Failure to maintain accurate information on file can have significant consequences.  

Access the Medicare Revalidation Lookup Tool to check on your due date every couple of weeks, using your LEGAL business name. You will get a letter as well if you are at the address reported on your last submitted 855A. 

For more information, contact Nancy Boyd, Senior Manager, Simione Healthcare Consultants, at
Cost Reporting Update: The Provider Statistical & Reimbursement Report (PS&R)

The PS&R accumulates statistical and payment data for Medicare providers including home health agencies (HHAs) and hospices. The PS&R is a critical element of your cost report preparation process if your billing software does not provide you with all the Medicare settlement data and flu vaccine information.  Agencies must register to receive their PS&R via the Enterprise Identity Management (EIDM) system.  We recommend that agencies register in the system NOW to avoid future potential problems.  

Why do I need the PS&R?
The Medicare cost report submitted by home health and hospice agencies every year contains cost information, statistical data and Medicare settlement data. It must be filed within five months after the end of the fiscal period.  Filing your cost report late will cause your Medicare payments to be reduced or suspended.  Providers have the option of using their internal information or the PS&R.

To register, go to  
On the EIDM Home Page, click on New User Registration to complete the online registration form.

Requesting Reports
When you receive your USER ID and Password, call Simione and we can walk you through the process of requesting the required reports to complete your Medicare cost report.

EIDM HELPDESK (External User Services)
Phone: 866.484.8049

For more information, contact Kathleen Cromwell by email at or call 800.949.0388.
Simione Team Members Advance Qualifications with Certifications 

Thomas BoydSimione's Vice President of Reimbursable Services, has earned the designation of Certified Healthcare Financial Professional (CHFP) from the Healthcare Financial Management Association (HFMA). The CHFP credential is awarded upon successful completion of HFMA's Business of Health Care program, and its Operational Excellence exam, and recognizes Tom's high level of technical knowledge, experience and skills in healthcare finance. A nationally recognized expert in Medicare reimbursement, he is also a Certified Fraud Examiner, and was inducted into the Hall of Fame at the 2013 National Association for Home Care and Hospice Financial Managers Conference. 

A growing number of Simione team members have obtained ICD-10 certification from the National Credentialing Board of Home Health and Hospice. Recent certifications include: Rachel Hawkins, BSN, Senior Manager, and Kim Skehan, RN, MSN, Senior Manager, as well as Simione Contractors Julia Faidley, Maureen McCarthy, Tammy Holden, Terry Holden and Amanda Patterson. The BCHH-C ICD-10 designation (Board Certified Home Health Coding) is granted upon passing a rigorous examination in the areas of health information documentation, diagnosis coding in ICD-10, OASIS, and regulatory compliance and reimbursement. 
Complimentary Webinars 

September 8, 2016 from 3-4 PM Eastern
NOE Tracker: Find Errors, Track Penalties & Boost Your Hospice Profitability

Presenters:  Rob Simione, Senior Manager, Simione Healthcare Consultants, and Ellie Robison, CEO, MedTranDirect

Is your hospice losing out on revenue due to NOE submission after the 5 day window? NOE Tracker is a first-of-its-kind software to help hospice organizations avoid thousands of dollars in lost monthly revenue. By automating the NOE submission process, hospices can avoid excessive data entry, create alerts when NOE have been RTPed, and create an audit trail for the appeals process. Hospices are also able to achieve an ROI on the tool in two months!  Join us for this brief, informative look at this tool to help you speed up and improve accuracy, eliminate redundant data entry and maximize revenue. 

September 27, 2016 @ 3-4:30 PM Eastern
Pre-Claim Review: Preparing for the Who, What, When, Where, Why & How

Presenter:  Julia Maroney, RN, MHSA, Director, Simione Healthcare Consultants

CMS has launched a Pre-Claim Review Demonstration for providers in five states (IL, FL, TX, MI, MA) that are enrolled in Medicare for home health services.  With activation of these states scheduled through January 2017, the program requires these HHAs to submit a pre-claim review request and the necessary documentation to their respective MAC for Medicare fee-for-service patients.  Join us to learn more about this CMS effort to increase program reliability by altering the reactive model of making payments and then "chasing down" fraudulent claims or improper payments.  Topics will include the rationale behind the demonstration, the steps involved in the process, and ways HHAs can prepare in terms of operations, claims submissions and staff development.
Join Us in 2 Weeks at the 3rd Annual Sales Leadership Conference

Viva Las Vegas!  Simione Healthcare Consultants is ready to welcome you to its 3rd Annual Strategic Growth and Sales Leadership Conference for two exciting days of networking and education on best practices in home care and hospice sales, marketing and referral management. 

3rd Annual Strategic Growth & Sales Leadership Conference
September 20-21, 2016 
The Cosmopolitan of Las Vegas

Registration Fee: $1,695 per person
Reserve your space with a $500 deposit

Day 1 - 9 AM to 5 PM with reception to follow
Day 2 - 9 AM to 4:30 PM
Mike Ferris, Principal, Simione Healthcare Consultants
Kathleen Hessler, RN, JD, Director, Simione Healthcare Consultants
Kara Justis, MBA, Director, Simione Healthcare Consultants
Melynda Lee, MBA, Senior manager, Simione Healthcare Consultants
Ken Lund, President, Nosilla Relyt Inc., and Healthcare Business Turnaround Specialist
Bill Simione, Principal, Simione Healthcare Consultants

Agenda Highlights
  • Gap Analysis: What Is My Desired Future State & How Will I Get There?
  • Creating a Digital Marketing Strategy for Your Organization
  • Ethics & Compliance in Home Care & Hospice
  • Harnessing the Power of Market Data to Laser In On the Right Targets
  • STAR Ratings & Outcomes
  • What is the Value of Growth?
  • Selling to MCOs & ACOs
  • Cementing Your Place in the Post-Acute Continuum
  • Overcoming Barriers to Success: How to Operationalize Findings from Gap Analysis

Simione Sales Training
December 5-7, 2016
Springhill Suites, Las Vegas

Day 1:  Pre-Bootcamp $495
Track 1: Simione Sales Management Workshop or
Track 2: Everything a Sales Professional needs to know about home health and hospice but didn't know where to ask.
Days 2 & 3: Square One Bootcamp  $895
Complete Package: $1,195 (must specify which track for day one)


Sept 8Home Care Association of New York State, Senior & Financial Managers Retreat, Mohonk Mountain House, New Paltz, NY
Sept 13-14Ohio Council for Home Care & Hospice Annual Conference, Hyatt Regency, Columbus, OH
Sept 14
The Virginia Hospices & Palliative Care Leadership Forum, Charlottesville, VA
Sept 15-17
Nurse Next Door Annual Conference, Vancouver Marriott Pinnacle Downtown Hotel, Vancouver, BC
Sept 19-21
Association for Home & Hospice Care of North Carolina Convention & Expo, Holiday Inn Resort, Wrightsville Beach, NC
Sept 20-21The 3rd Annual Simione Strategic Growth & Sales Leadership Summit, The Cosmopolitan of Las Vegas, Las Vegas, NV (Register at
Sept 27McKesson Users Conference, Grand Hyatt, San Antonio, TX
Oct 2-4Midwest Regional Conference & Palliative End of Life Care Conference, Tan-Tar-a Resort, Lake of the Ozarks, MO

Develop Your Roadmap
for Success
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NOE Tracker
Reduce errors and lost monthly revenue! NOE Tracker validates data, clarifies status, making the process faster and easier
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Leading Industry Benchmarks
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Billing, Coding & OASIS Review 
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Interim Management Services
Seasoned executives to support smooth transitions in operations and at your leadership table

Founded in 1966, Simione™ Healthcare Consultants provides comprehensive business solutions for home health and hospice in the areas of operations, compliance & risk, finance, sales & marketing, cost reporting, information technology, and mergers and acquisitions.  Simione's experts and tools support performance improvement across the healthcare continuum, engaging agencies, hospitals and health networks to improve quality, reduce cost, and minimize risk for more effective delivery of patient care.