This two-day workshop will take agencies through the current state of the Patient-Driven Groupings Model (PDGM) and move through all the aspects of Medicare home health reimbursement.
The PDGM has brought many changes to home health and the PDGM is not all that reimbursement is made up of. In addition to working through the fine details of the PDGM changes, the workshop will also cover extensive examples for Low Utilization Payment Adjustments (LUPAs), Partial Episode Payments (PEPs), and outlier adjustments. There will be a discussion of pre-billing claim reviews and the significance of them.
The impact of OASIS, ICD-10 coding, and medical review programs have the potential to more directly impact reimbursement than some of the other aspects of the PDGM, and this workshop will get you up to date on all of that as well. Additionally, with cash flow being one of the gravest areas of concern for providers in recent months, this workshop will take you through the basics of cash flow projections and how best to make that work in your organization.
Whether you are a biller, collector, or administrator, this workshop is just what is needed to get you up to date on all things home health reimbursement.
What is billable and non-billable in today’s COVID-19 pandemic world? Can you bill for telehealth visits? Does your physician and non-physician practitioner telehealth face-to-face encounter contribute to your patient eligibility for home health? These and many other questions will be answered in this information-packed two-day workshop. Don’t miss the opportunity to hear strategies and lessons learned during this public health emergency from national speaker Melinda Gaboury, CEO of Healthcare Provider Solutions, Inc.
During this workshop providers will learn why it’s so important to understand the billing flexibilities that were afforded to Medicare providers to ensure cash flow doesn’t stop. If one or more,of these billing parts are missing or are incorrect, agencies set themselves up for denials, Additional Documentation Requests, and a host of other billing dilemmas that should be avoided. Participants will walk away with a much clearer understanding of Medicare billing practices under the PDGM and COVID-19.
Tuesday, June 9: Day-to-Day Revenue Cycle Under the PDGM with COVID-19 Updates
- Evaluate the PDGM Structure
- Detail the significant impact of intake on revenue cycle
- Health Insurance Prospective Payment System (HIPPS) code and episode exceptions review
- LUPA, PEP, and outlier calculations
- Describe the process for effectively auditing a chart for purposes of identifying pre-bill issues, including non-routine supplies
- Details of billing Requests for Anticipated Payment (RAPs) and final claims
- OASIS and ICD-10 coding impact on reimbursement
Thursday, June 11: Home Health Reimbursement: Beyond the PDGM with COVID-19 Updates
- OASIS and ICD-10 coding
- Medicare secondary payer
- Detail credentialing with managed care and issues surrounding getting paid
- Establish processes for effectively monitoring ADR/Recovery Audit (RA), and Unified Program Integrity Contractor (UPIC) reviews
- Monitoring and evaluating your Program for Evaluating Payment Patterns Electronic Report (PEPPER)
- Factoring the Review Choice Demonstration into the PDGM
Attendance for the entire program is required to earn continuing education units. A copy of the completed Continuing Education Certificate must also be submitted. This program will provide 6.5 contact hours per day to for skilled nursing, occupational therapy, and speech therapy.
Meet the Speaker
Melinda A. Gaboury, COS-C, is Chief Executive Officer of Healthcare Provider Solutions, Inc.. With more than 28 years in home care, she 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. Audit appeals (i.e., ZPIC, RA, ADR, and TPE) with all Medicare Administrative Contractors have become the forefront of Melinda’s current impact on the industry. She is currently serving on the National Association for Home Care & Hospice (NAHC) Home Care and Hospice Financial Managers Association (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.
Save Your Spot…Register Now!
Register online or call (850) 222-8967 to register by phone. HCAF members receive a discounted registration rate! To obtain the member discount, please log in to your profile before registering. Registration fees are as follows:
||Single Day Registration
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|HCAF Private Duty Member
Please log in to the program at least 15 minutes prior to the start time. Additional logins will be charged an additional registration fee. By registering for this event, you are agreeing to our payments, cancellation, and substitution policies.
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