/r/DnB/ on SoundCloud - Mixes and tracks by Reddit producers and DJs.No ticket swap/repurchases - we don't have means to police the scammers so please take the transaction elsewhere. Self-promotion is allowed, but if it takes up the majority of your post history it will be treated as spam.
No piracy, support the industry you love. If you want to submit a lot of tracks at once, you are welcome to make a self-post and group the links within in.Įvent promo allowed but don't take the piss. Do not flood the subreddit with your own posts. If posting a track: put the artist/track name in the title and search before posting, reposts within 6 months will be removed. Posting Rules ( expanded /w explanations): Discuss & share links to tunes and mixes. The new Patient-Driven Groupings Model (PDGM) takes effect January 1, 2020.A place on reddit for the dnb massive. When I looked a little bit deeper at the claim, I spotted the reason for the discrepancy and explained that the patient’s episode was a LUPA.Īn updated version of this article explaining the PDGM impact on a LUPA is available here.Ī few weeks ago, a customer contacted our Support Center with a bad wintertime case of “billing confusion.” She had been reviewing her Medicare remittance advices and had noted that for one of her patients, she had received a reimbursement of only about $500, when, in fact, she had been expecting a reimbursement of around $2800. “A LUPA?” she replied, seemingly puzzled. Unfortunately, her puzzlement at my response was not uncommon. Indeed, we seem at times to speak a foreign language! Most of us in the home health industry have become familiar over time with the many acronyms used in our business – SOC, ROC, TIF, OASIS, HHRG, HIPPS, RAP, and many others. However, one acronym in particular – LUPA – seems to be a source of perpetual confusion for many of our clients. The term itself stands for “Low Utilization Payment Adjustment,” which seems simple enough. However, the real significance of the LUPA comes into play in terms of how we are reimbursed for patient care.
LUPA DUBPLATE SERIES
That said, let’s take a look at a “typical” episode of care in terms of reimbursement and then contrast that to the LUPA.įor most home health episodes of care, we generally see the patient for a series of weeks.
In many instances, one or more disciplines work together, and frequently we recertify our patients to meet their ongoing care needs. For example, a typical frequency and duration might be 1W9 for nursing and 2W5 for physical therapy. This would, of course, result in our agency performing quite a few patient visits – 19 in the above example. In this instance, we would be reimbursed “episodically.” In other words, Medicare would pay us a set “episode” amount for our care. That amount would reflect the acuity or “case mix” of the patient based upon the OASIS assessment and episode timing. For 2014, the national standardized base fee for a 60 day episode is $2,869.27. In some instances, the “rules” we talked about above don’t apply. In a LUPA episode, the home health agency sees the patient for 4 or fewer total visits. Therefore, these episodes are “low utilization” (i.e. not “utilizing” much of our resources.) Accordingly, Medicare deems these episodes as necessitating a “payment adjustment.” Thus, we end up with the LUPA episode. As mentioned above, the LUPA episode occurs when 4 or fewer billable visits are performed. It is important to note, however, that all billable visits, regardless of discipline, count toward meeting the visit threshold. This includes visits by nursing, social work, home health aides, and physical, occupational, or speech therapy. For 2014, the national per visit amounts before wage index adjustments are found in the table below 2: In the event a LUPA episode occurs, the agency is not reimbursed “episodically,” but instead on a per visit basis.
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