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Speaker(s): Melinda A. Gaboury, CEO
About the Speaker(s)
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 AHC/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 and Home Health Billing Answers, 2021.
About the Event
Hospice Medical Review in a Medicare Certified World is scheduled on Wednesday, April 27, 2022 from 1:45 – 3:15 p.m.
This session will take agencies through the winding road of Medicare scrutiny. While billing the Medicare benefit and getting paid relatively easy, there is always a risk of things being reviewed at some point and what can you do to avoid denials. Participants will be able to define Targeted Probe & Educate (TPE) and outline the structure of how to respond to any level of medical review that may occur, including UPIC, RA, SMRC. This session will also discuss PEPPER reports and other data analysis that agencies will need to review to ensure that their risk from medical review is limited. Don’t be caught in the comfortable position of believing that everything is okay. Attendees will take away information that will assist in assuring that your hospice truly is accurately documenting.
Calculations of the Total Performance Score is scheduled on Thursday, April 28, 2022 from 4:00 -5:30 p.m.
Value Based Purchasing full implementation is set to begin January 2023. There is much to learn about the details of the outcome calculations. This session will take you through the detail calculations of the VBP Model. It will look at how the agencies did in the demonstration that took place in 9 states. It will also detail what we know to be the calculations of the TPS and the Linear Exchange Function for the nationwide rollout.
- Detail the calculation process and statistics from the demonstration for Home Health VBP
- Review what agencies should do to prepare for nationwide rollout coming in 2023
- Detail the calculation of the Total Performance Score – Improvement & Achievement
- Review examples of the Linear Exchange Function calculation used to determine impact on future payments
Specific OASIS Questions and Tips on Getting Them Correct that Impact Value Based Purchasing is scheduled on Friday, April 29, 2022 from 8:00 – 9:30 a.m.
Value Based Purchasing full implementation is set to begin January 2023. There is much to learn about the details of the outcome calculations. This session will take you through the details of the specific OASIS items that will be used in the VBP outcomes calculations and how each question should be responded to.
- Review the changes to the measures included in HHVBP
- Detail the functional M1800 items included in the Composite Mobility Measures
- Evaluate the best clinical practices for getting the best outcomes.