Tina Marie Pellis

• Perform comprehensive home health documentation reviews within multiple EMR systems. The reviews are focused on coding and OASIS accuracy in accordance with regulations.
• Review clinical OASIS (SOC/ROC/Recert assessments) and 485 data to ensure accuracy, appropriateness, congruency, completeness, and compliance with federal and state regulations and client policy
• Ensure appropriate ICD-10 coding and sequencing as it relates to the patient’s medical condition
• Consult with appropriate clinical staff to clarify any data integrity issues and appropriate corrections per policy.
• Serve as a resource for clinicians regarding OASIS, coding, and PDGM guidelines, enhancing compliance and understanding Assisted with other record review activities.

• Review and validate OASIS assessments (SOC, ROC, Recert) and related 485 data for accuracy, completeness, and compliance with federal/state regulations.
• Identify and correct discrepancies or errors in OASIS data, collaborating with clinicians to ensure proper documentation.
• Transferred OASIS data to Medicare electronically to Medicare in compliance with CMS requirements
• Review ICD-10 coding and sequencing from patient chart documentation to ensure accuracy and appropriateness
• Document recommended changes and assess potential reimbursement impact

• * Reviewed clinical documentation
• * Assigned correct codes: ICD 10 that aligned with CMS PDGM and payer specific rules
• * Reviewed oasis for valid assessment and 485 data for appropriateness, congruency, and completeness
• * Collaborated with clinicians to clarify documentation gaps and inconsistencies while recommending corrections.
• * Ensured compliance to optimize reimbursement.

• Review home health documentation in multiple EMR systems for accuracy, completeness, and compliance.
• Perform detailed ICD-10 coding for home health episodes, ensuring alignment with clinical documentation and payer requirements.
• Audit and validate OASIS data sets for accuracy, consistency, and adherence to CMS guidelines.
• Communicate with agency staff to clarify documentation and resolve discrepancies.
• Stay current with CMS regulations, ICD-10 updates, and OASIS guidance to ensure ongoing compliance.
• Provide feedback and education to agency partners to improve documentation quality and coding accuracy.

Ensured accurate, compliant, complete documentation for patients receiving home care, combining clinical coding expertise with OASIS review to support Medicare, Medicaid, and private insurance reimbursement while meeting CMS and agency compliance standards.

• Review clinical documentation: Examine physician notes, nursing assessments, therapy records, referral forms, and OASIS responses for accuracy, completeness, and compliance.
• Assign correct codes: Apply ICD-10-CM diagnosis codes and CPT procedure codes in alignment with CMS PDGM and payer-specific rules .
• OASIS review: Validate SOC/ROC/Recert assessments and 485 data for appropriateness, congruency, and completeness.
• Collaborate with clinicians: Clarify documentation gaps or inconsistencies with nurses, therapists, and coordinators; recommend corrections.
• Ensure compliance: Adhere to CMS home health regulations, OASIS guidelines, and agency policies to reduce audit risk and denials.
• Optimize reimbursement: Support accurate coding to maximize appropriate payment without overbilling.
• Stay current: Monitor changes in coding rules, OASIS updates, and PDGM requirementsers+1.

• Conducted thorough assessments and evaluations, identifying patient needs and tailoring interventions accordingly.
• Coordinated comprehensive care plans for diverse patient populations to ensure optimal health outcomes.
• Collaborated with interdisciplinary teams to enhance communication and streamline care delivery processes.
• Educated patients and families on disease management, medication adherence, and preventive health measures.

• Conducted thorough assessments and evaluations, identifying patient needs and tailoring interventions accordingly.
• Implemented quality improvement initiatives that enhanced patient satisfaction scores and reduced hospital readmissions.
• Worked with a multidisciplinary team to carry out successful treatment plans for diverse acute and chronic conditions.
• Strengthened patient adherence to prescribed medications and treatments by providing clear instructions and addressing any concerns or barriers.
• Conducted comprehensive assessments of patients'' physical, emotional, social, and environmental needs to develop individualized care plans.
• Prevented complications by promptly identifying potential issues and taking appropriate action to address them.
• Improved patient outcomes by implementing personalized care plans and closely monitoring progress.