Speaker(s): Melinda A. Gaboury, CEO
About the Speaker(s)
Melinda A. Gaboury, with more than 30 years in home care, has over 22 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 as the Chair of the NAHC/HHFMA Advisory Board and Work Group and is currently serving on the Board of Directors for both the Home Care Association of Florida & Tennessee Association for Home Care. Melinda is also the author of the Home Health OASIS Guide to OASIS-E and Home Health Billing Answers, 2023.
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About the Event
Wednesday, June 25
1:15pm
Home Health Defensible Therapy Documentation: How to Avoid Denials
Speaker: Melinda Gaboury, CEO
This session will get you moving and improving your therapy documentation. Considering all the pressures of limited time, regulations, never-ending audits, and the denial of payments due to lack of medical necessity, therapist must refine their documentation skills to ensure they can support and justify the need for therapy Home Health services. In this webinar we cover the regulatory requirements for medical necessity, how to recognize common mistakes and recognize through examples appropriate documentation. Participants will learn what is required in documentation to support skilled therapy services for reimbursement and skillfully paint a picture of the patient’s care in the notes.
Thursday, June 26
11:00am
Medicare Advantage: Digging Into the Details
Speaker: Melinda Gaboury, CEO
Home Health providers are grappling with the shift in the Medicare eligible population into Medicare Advantage Plans (MA Plans). Providers are asking: What are the implications of current demographic trends? What operational and financial issues should providers expect as their payer mix shifts to mostly Managed Care? Being successful in this environment of these payer mix changes requires agencies to understand their costs of treating these patients and other impacts on their operations on an individual contract basis. This session will assist with details that are needed to identify specific elements of contracts under Medicare Advantage. This session will also review key elements for successfully accepting patients, receiving authorization and billing Medicare Advantage claims. Learning Outcomes include: Define the Medicare Saturation nationwide; Review tips for evaluating contracts and Detail key elements of successfully implementing a new contract.
1:15pm
Hospice Medical Review in a Medicare-Certified World
Speaker: Melinda Gaboury, CEO
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, RAC, SMRC audits. This session will also discuss data analysis that agencies will need to review to ensure that their risk from medical review is limited. Attendees will take away information that will assist in assuring that your hospice truly is prepared for medical review.