1. Barriers: Back up Team & Cost Outs
Planning for Success
Barriers: Back up Team & Cost Outs

2. Timeliness, Accuracy, Cost Outs:
PHC Policy is to turn around referrals in 1 hour!
How can we get this done?
Just say YES!!
Know what you can and can’t take
Be ready to Cost Out referrals
Make sure Back Up team is in place
Understand the difference between accepting and admitting
Understand as much as you can about payer sources
Know who your resources are if you need assistance(Medicaid questions, insurance problems, equipment holdups, etc)

3. Cost out Tool
Open Discussion

4. Cost Out Rate Sheet Recover Care Pricing
Alternating Pressure Low Air Loss Mattress- $10.50/day
With Bolister Sides- add $1/day
Bariatric Alternating Pressure Low Air Loss Mattress- $10.00/day
With Bolister Sides- add $1/day
Bariatric Bed Frame (750lb)- $25.00/day, (1000lb)- $35.00/day
Bariatric Commode (700lb)- $3.00/day
Bariatric Rolling Walker (700lb)- $1.00/day

5. Rates Continued Wheelchairs- 24in Wheelchair (450lbs)- $7.00/day
26in Wheelchair (700lb)- $9.00/day
28in Wheelchair (700lb)- $9.00/day
30in Wheelchair (700lb)- $9.00/day
Bariatric Lift (600lb capacity) with scale- $13.50/day
Bariatric Lift (1000 lb capacity) with scale- $26.25/day
Bariatric Trapeze- $3.00/day
CPM Machine- $24.95/day, with Shoulder Kit- $37.50/day
Exsudex Negative Pressure Pump- $35.00/day
Kit- $550.00/1 month supply
KCI Wound Vac- $61.25/day

6. Rates - therapy
Rehab Care Pricing *Please note- The prices below are per day, but you pay this daily rate for Therapy and NON-treatment days. These are our costs NOT private pay rates.
RU Category- $110.06/day
RV Category- $76.43/day
RH Category- $49.68/day
RM Category- $22.93/day
RL Category- $6.88/day
Non-Rehab Rug- $1.07/minute
Medicaid Only Patients- $1.00/minute

7. Rates SMS BiPap Machine- $231.00/month BiPap ST- $393.75/month
Compression- $42.00/month
Concentrators- $39.90/month
CPap- $84.00/month
Oxygen- .40/pound
Portable Stroller- $15.75/month
Heater- $78.75/month
10L Oxygen Concentrator- $78.75/month
Auto CPap- $157.50/month
Trach- 1 time per month Consult- Double check with SMS on pricing for your building

8. Rates – Omni Care IV Hydration- $20.00/day
TPN- Up to 1000ml (includes Detrose, A.A., Electrolytes, trace elements, and lipids)- $80.00/day
From 1001ml to 2000ml(including the above)- $100.00/day
Greater than 2001ml(including the above)- $110.00/day
IVs - 1st IV/day(including pump/CADD pump and supplies)- $17.00/day
2nd IV/day(including the same)- $20.00/day
3rd IV/day(including the same)- $25.00/day
QID IV/day(including the same)- $30.00/day
Continuous IV Pain Infusion- $35.00/day
Does NOT include cost of medication

9. Rates - Misc Miscellaneous
*We do not take Triligy AVap/BiPap! – Considered VENT
Shaker Vest- $ /month PLUS suction machine and supplies
Life Vest- $4000/month
*Both Shaker Vest and Life Vest are not reimbursed in LTC. Part B will pay for these at home.

10. Final Thoughts:
Keep it at your finger tips for quick reference
Makes costing out easier
If a supply is missing from this list, please let me know and I will get it for you

11. We are a 24/7 business and our referral sources expect that of us.
Back Up Tool
Why do we need it?
We are a 24/7 business and our referral sources expect that of us.
Why and How?

12. A Successful Back Up Team
Provides coverage for your referrals and admissions 24/7
Maintains high quality and Consistent Customer Service
Empowers employees
Grows Census
Improves relationships with referral sources
Meets PHC policy requirements

13. Make it work for you
Who is on it? Who should be on it? Is there enough depth to it? Train the Back Up team on their responsibilities. Utilize those on the Back Up team several times a year to make sure they are comfortable performing their responsibilities flawlessly when needed.

14. Admission Team Tool
Time to designate the A- TEAM