Home Healthcare Home Health & Hospice Care Dallas, TX (350 Active Patients)
Comfort Care Home Health: Master OASIS Coding & Eliminating RAP Submission Delays
Optimizing OASIS documentation, Request for Anticipated Payment (RAP) submissions, and Medicare PDGM billing.
Published June 2026 6 min read
24 Hours
RAP Submission Speed
Reduced from 8 days
+19%
PDGM Revenue Increase
From accurate OASIS functional scoring
1.2%
Denial Rate
Down from 14.5%
The Challenge
- Delayed RAP submissions resulting in Medicare late filing penalties.
- Inaccurate OASIS functional domain scoring lowering Patient-Driven Groupings Model (PDGM) reimbursements.
- LUPA (Low Utilization Payment Adjustment) thresholds triggered unexpectedly.
The Solution & Strategy
- Assigned certified OASIS coders to review clinical documentation within 24 hours of start of care.
- Automated RAP electronic filing directly upon OASIS lockout completion.
- Integrated LUPA visit count tracking alerts to notify clinical managers before threshold breaches.
Quantifiable Key Results
RAP Submission
24 Hours
87% faster submissionPDGM Yield
+19%
Higher legitimate reimbursementLUPA Penalties
0%
Completely eliminated"OASIS coding accuracy directly impacts our home health revenue under PDGM. YAKKAY Healthcare increased our reimbursement yield by 19%."
Brenda Collins, RNDirector of Nursing at Comfort Care Home Health
Actionable Takeaways for Practice Leaders
1
Review OASIS functional scoring within 24 hours of patient start of care to optimize PDGM clinical grouping2
Set automated visit count alerts to prevent unexpected Low Utilization Payment Adjustments (LUPA)Ready to Achieve Similar Results?
Schedule a complimentary Revenue Cycle Audit for your practice to pinpoint billing leaks and clean claim opportunities.
Organization Profile
Organization:Comfort Care Home Health Agency
Specialty:Home Health & Hospice Care
Location & Scale:Dallas, TX (350 Active Patients)
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