PDGM Compliance with TYNE EHR

Complete guides for Patient-Driven Groupings Model compliance, billing workflows, and documentation using TYNE EHR software. Ensure accurate home health billing and maximize reimbursement with our comprehensive PDGM tools.

98%

PDGM Accuracy Rate

60% Faster

Billing Processing Time

100% CMS Compliant

TYNE EHR PDGM Calculations

PDGM Implementation with TYNE EHR

TYNE EHR provides comprehensive PDGM compliance tools designed specifically for home health agencies to streamline billing and documentation

Automated PDGM Calculations

TYNE EHR automatically calculates case-mix weights, functional levels, and comorbidity adjustments for accurate PDGM billing.

Documentation Validation

Real-time validation of OASIS-E assessments to ensure PDGM compliance and accurate clinical grouping.

Billing Workflow Automation

Streamlined billing processes with automated PDGM coding, claim generation, and submission to CMS.

PDGM Workflow in TYNE EHR

Follow this step-by-step workflow to ensure complete PDGM compliance using TYNE EHR software

1

Initial Patient Assessment

Complete comprehensive OASIS-E assessment using TYNE EHR's standardized forms with built-in validation rules.

OASIS-E Module Assessment Forms
2

Clinical Grouping & Comorbidity Adjustments

TYNE EHR automatically assigns clinical grouping and calculates comorbidity adjustments based on assessment data.

Clinical Grouping Engine Comorbidity Calculator
3

Functional Scoring & Case-Mix Weights

System calculates functional impairment levels and applies appropriate case-mix weights for PDGM reimbursement.

Functional Scoring Case-Mix Calculator
4

Billing & Claim Generation

Generate PDGM-compliant claims with accurate HIPPS codes and submit directly to CMS through TYNE EHR.

Billing Module Claim Generator

18 PDGM Compliance Articles

Complete guides for implementing and managing PDGM compliance using TYNE EHR software

Essential

1. Understanding PDGM in TYNE EHR

Overview of Patient-Driven Groupings Model and how TYNE EHR implements PDGM compliance for home health agencies.

Essential

2. PDGM Configuration in TYNE EHR

Step-by-step guide to configuring PDGM settings, thresholds, and parameters in your TYNE EHR system.

Essential

3. PDGM Billing Workflow in TYNE EHR

Complete billing workflow from assessment to claim submission using TYNE EHR's PDGM tools.

Intermediate

4. HIPPS Code Generation with TYNE EHR

How TYNE EHR automatically generates accurate HIPPS codes for PDGM billing and claim submission.

Essential

5. OASIS-E Assessment for PDGM

Complete guide to conducting OASIS-E assessments that support accurate PDGM clinical grouping in TYNE EHR.

Intermediate

6. Clinical Grouping Methodology in TYNE EHR

How TYNE EHR assigns clinical groups based on principal diagnosis and other assessment factors.

Intermediate

7. Case-Mix Weight Calculations

Understanding how TYNE EHR calculates case-mix weights and functional impairment levels for PDGM.

Essential

8. Documentation Requirements for PDGM

Essential documentation elements needed in TYNE EHR to support PDGM billing and compliance.

Advanced

9. Low-Utilization Payment Adjustments (LUPA)

Managing LUPA thresholds and documentation requirements using TYNE EHR's PDGM tools.

Intermediate

10. Admission Source & Timing in PDGM

How TYNE EHR handles admission source and timing categories for accurate PDGM billing.

Essential

11. PDGM Claim Submission Process

Step-by-step guide to submitting PDGM-compliant claims to CMS using TYNE EHR's billing module.

Intermediate

12. Comorbidity Documentation & Coding

Documenting and coding comorbidities in TYNE EHR to support PDGM clinical grouping and adjustments.

Advanced

13. PDGM Audit Preparation with TYNE EHR

Using TYNE EHR reports and documentation tools to prepare for PDGM compliance audits.

Intermediate

14. Outlier Payments & Adjustments

Managing outlier payments and understanding adjustment calculations in TYNE EHR's PDGM module.

Essential

15. PDGM Reporting in TYNE EHR

Generating PDGM compliance reports, financial analyses, and performance metrics using TYNE EHR.

Advanced

16. PDGM Optimization Strategies

Advanced strategies for maximizing PDGM reimbursement using TYNE EHR's analytics and reporting tools.

Intermediate

17. Functional Assessment Documentation

Documenting functional assessments in TYNE EHR to support accurate PDGM functional scoring.

Essential

18. PDGM Billing Error Prevention

Common PDGM billing errors and how to prevent them using TYNE EHR's validation and checking tools.

PDGM Reimbursement Estimator

Estimate PDGM reimbursement using TYNE EHR's calculation methodology (Simplified version)

PDGM Payment Estimator

This tool provides an estimate based on TYNE EHR's PDGM calculation engine. Actual payments may vary.

PDGM Compliance Best Practices

Essential tips for maintaining PDGM compliance using TYNE EHR software

Complete OASIS-E Assessments

Ensure all OASIS-E assessments are complete and accurate. TYNE EHR provides validation tools to catch errors before submission.

Accurate ICD-10 Coding

Use TYNE EHR's coding suggestions and validation to ensure accurate ICD-10 codes for proper clinical grouping.

Document Comorbidities

Thoroughly document all comorbidities using TYNE EHR's structured forms to support accurate adjustment calculations.

Monitor LUPA Thresholds

Use TYNE EHR's visit tracking to monitor Low-Utilization Payment Adjustment thresholds and avoid reduced payments.

Regular PDGM Audits

Conduct regular internal audits using TYNE EHR's reporting tools to identify and correct compliance issues early.

Stay Updated on Changes

TYNE EHR automatically updates PDGM calculations with CMS changes, but staff should stay informed of policy updates.

Need PDGM Compliance Help?

Our PDGM compliance specialists can help you optimize your billing and documentation workflows using TYNE EHR

Schedule PDGM Consultation

PDGM Compliance Audit

Comprehensive review of your PDGM documentation and billing practices using TYNE EHR

PDGM Training Sessions

Customized training for your clinical and billing staff on PDGM compliance with TYNE EHR

Workflow Optimization

Optimize your PDGM workflows to maximize efficiency and reimbursement using TYNE EHR