Home health RAP denials are spiking. Here's the fix.
Home health Request for Anticipated Payment (RAP) denials concentrate in timing, OASIS completion, and Plan of Care signature. Each is fixable with disciplined workflow. This page covers the playbook.
The RAP denial patterns
Late RAP submission past 5-day window (auto-cancellation or payment penalty). OASIS-E incomplete or late. Plan of Care not physician-signed within window. Missing face-to-face encounter documentation. Verification element gaps.
The 5-day RAP discipline
RAP must be submitted within 5 calendar days of Start of Care. Calendar workflow tracking each new SOC with 5-day countdown. Daily review of pending RAPs. No exceptions. The 5-day window is unforgiving.
OASIS-E completion workflow
Comprehensive Assessment within 5 days of SOC. Documentation routed to coding within 24 hours. Coding completion within 48 hours. RAP submission as soon as coding complete. Time pressure is built into the cycle; only disciplined workflow keeps it on track.
Plan of Care signature tracking
Physician POC signature within window is non-negotiable. Track signature status daily. Escalate at 48-hour pending status. Have backup MD on contract for emergency POC signatures.
Face-to-face encounter documentation
F2F encounter prior to SOC (with specific date + provider). Documentation in clinical notes. Reference in OASIS + POC. Missing or unclear F2F documentation = audit recoupment risk.
Free home health RAP audit
Send us your last 30 days of RAP submission timing + denial reasons. We return diagnostic identifying workflow gaps + 30-day improvement plan.
Don't wait. Get a senior partner on this.
ASP-RCM senior partners do same-day consultations on operational distress situations. 30 minutes. No SDR triage. Diagnostic conversation. You leave with a plan whether or not you engage us further.