Part 1: Intake, Orders, Prebill Audits
THURSDAY, FEBRUARY 6, 2020 • 12:30-2:00 PM ET
The Patient Driven Groupings Model (PDGM) became effective on January 1, 2020. This is the most significant change to the home health care industry reimbursement structure since the introduction of the current Prospective Payment System (PPS) in October 2000. The new payment model dramatically impacts agency operations, processes and performance. Home health agencies must develop and implement plans to successfully transition to the PDGM now. This webinar presentation will review key areas, strategies, and processes in preparing an agency for the PDGM. The speaker will focus on the changes to the 30-day payment model, which will bring significant back office changes, specific to the claims processing and collections.
- Summarize key areas of agency operations impacting revenue cycle under the PDGM;
- Discuss necessary modifications to the intake and referral process under the PDGM, including face-to-face requirements;
- Review order management; and,
- Review significant pieces of the pre-bill audit process.
Part 2: Billing & Collecting RAPs & Final Claims
MONDAY, FEBRUARY 10, 2020 • 12:30-2:00 PM ET
The PDGM brings many changes to the billing process, including doubling 75% of the volume of claims for current Medicare episodes compared to 2019 that will be sent, as well as multiple changes to claims data. With RAPs (Requests for Anticipated Payment) and final claims now required every 30 days instead of 60 days, agencies may need to expand their revenue cycle teams. This webinar will cover details regarding the actual billing changes that will need to occur under the PDGM. We will take you through the details of billing under the PDGM and will review the process that the Medicare Administrative Contractor will go through to calculate the HIPPS code and pay claims. Lastly, this webinar will cover the proposed changes from a RAP to NOA (Notice of Admission) for 2021. There will also be a discussion of the overall impact on the revenue cycle under the PDGM.
- Review the PDGM billing changes;
- Detail the changes to the billing process under the PDGM ;
- Detail the specific changes to RAPs and final claims that is currently available;
- Review the specific impact on billing under the PDGM if agency is under the Review Choice Demonstration; and,
- Review the revenue cycle structure and the key points at which tweaks will need to be made under the PDGM.
Click here to download a printable event flyer.
Each session will provide 1.5 continuing education units to registered nurses, occupational therapists, and speech therapists.
MELINDA A. GABOURY • CEO • HEALTHCARE PROVIDER SOLUTIONS
Melinda A. Gaboury, COS-C, with more than 28 years in home care, has over 18 years of executive speaking and educating experience, including extensive day to day interaction with home care and hospice professionals. She routinely conducts home care and hospice reimbursement workshops and speaks at state association meetings throughout the country. Melinda has profound experience in Medicare Prospective Payment System training, billing, collections, case-mix calculations, chart reviews, and due diligence. UPIC, RA, ADR, and TPE appeals with all Medicare Administrative Contractors have become the forefront of Melinda’s current impact on the industry. She is currently serving on the NAHC/HHFMA Advisory Board and Work Group and is Associate Director on the Home Care Association of Florida Board of Directors. Melinda is also the author of the Home Health OASIS Guide to OASIS-D1.
Registration & Fees
Save time and travel costs and include all your billing, intake, and management staff who will benefit from this online education! Register online at HomeCareFLA.org or call (850) 222-8967. Fees increase $10 the day of the session.
- • HCAF Certified Members: $59/session or $108/series
• HCAF Associate Members: $59/session or $108/series
• HCAF Private Duty Members: $79/session or $148/series
• Prospective Members: $108/session or $206/series
HCAF offers a multitude of ways for home care industry vendors to promote products and services, including through educational program sponsorships. Gain additional exposure for your organization by sponsoring this program! Click here for sponsorship information, fees, and additional opportunities.