Melinda A. Gaboury, with more than 29 years in home care, has over 20 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 PDGM training, billing, collections, case-mix calculations, chart reviews and due diligence. UPIC, RA, ADR & TPE appeals with all Medicare MACs 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 Treasurer on the Home Care Association of Florida Board of Directors. Melinda is also the author of the Home Health OASIS Guide to OASIS-D1.
PROGRAM INTEGRITY; UPDATE ON TPE, SMRC, UPIC, AND OTHER CLAIM RECOVERY EFFORTS BY CMS (CONCURRENT) | Monday, September 19, 2022 (10:30 a.m. – 12:10 p.m.)
The Centers for Medicare and Medicaid Services (“CMS”) Center for Program Integrity (“CPI”) is claiming millions of dollars have been improperly paid to hospice agencies. These CPI audits review hospice records to ensure the patients are eligible for service, the service provided is appropriate and the providers are authorized to deliver the care. Claim recoveries can take various forms, including Targeted Probe and Educate (“TPE”), Supplemental Medical Review Contractor (“SMRC”) reviews, Unified Program Integrity Contractors (“UPIC”) reviews, and other reviews resulting in claim denials. Post COVID, an acceleration of these programs is expected. This session will focus on current and planned activities, including identification of risk. PEPPER Report highlights and their importance will also be discussed.
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What you'll get:
Recorded Home Care & Hospice Webinars
2 Medicare Compliance & Reimbursement Workshops in Nashville, TN
Compliance & Reimbursement Training Video Series
Home Care & Hospice Audit Tools
Consulting Support from HPS Staff via the Member Portal