AHHC Hospice & Home Health Billing Workshops
Speaker(s): Melinda A. Gaboury, CEO
Category: Speaking Engagement
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AHHC of NC
About the Event
Speaker: Melinda A. Gaboury
Tuesday, October 27, 2020 | 9:00am – 4:00pm | Home Health Reimbursement: PDGM & Beyond
This workshop will take agencies through the current state of PDGM and move through all the aspects of home health reimbursement. PDGM has brought many changes to home health and PDGM is not all that reimbursement is made up of. In addition to working through the fine details of PDGM changes the workshop will also cover examples for LUPA, PEP and Outlier adjustments. There will be a discussion of Pre-Bill claim reviews and the significance of that. The impact of OASIS & Coding and medical review programs have the potential to more directly impact reimbursement than some of the other aspects of PDGM and this workshop will get you up to date on all that. Cash flow has been one of the gravest areas of concern in recent months….let us 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.
1. Evaluate the PDGM Structure
2. Detail the significant impact of Intake on Revenue Cycle
3. HIPPS Code & Episode Exceptions Review
4. LUPA, PEP & Outlier Calculations
5. Details of Billing RAP & Final Claim
6. OASIS & Coding Impact on Reimbursement
7. Detail Credentialing with Managed Care & Issues surrounding getting paid
8. Targeted Probe & Educate
9. PEPPER Reports – monitoring and evaluating
Wednesday, October 28, 2020 | 9:00am – 4:00pm | Hospice Reimbursement Workshop 2020
Changes to the Medicare Hospice Regulations have occurred over the past few years and continue. Is your hospice thriving? Has your hospice adapted to budgeting for the new rates for 2021? Do you know where your agency stands in regard to PEPPER targets? Be among the elite group of hospice professionals that are current on all Hospice Medicare reimbursement related regulations. This workshop will lay a concrete foundation for hospice billers, as well as, any hospice staff that need to more effectively understand the Medicare regulations. This workshop will include field by field on Notice of Election, NOTR, claim forms and sequential billing requirements. The 2020/21 Claims Requirements will be detailed including a review of the new Routine & other levels of Hospice rates will be conducted. The workshop will detail the CMS Targeted Probe & Educate demonstration while also reviewing the regulations for face-to-face encounters and pre-claim reviews that should be conducted prior to filing claims. The workshop will conclude with analyzing the PEPPER information and how hospices can work toward improvement in their scores. If you have any part in the responsibility of reimbursement in your hospice this workshop is a must.
At the conclusion of the webinar, participants will be able to:
1. List the basic eligibility requirements for initiating Hospice and Billing to Medicare
• Conduct overview of eligibility requirements for the Hospice Benefit.
• Review Benefit Periods & Eligibility
• Review Notice of Election details
2. Detail criteria for line item billing Hospice Notice of Election and Claims to Medicare
• Review line item requirements including 15-minute increments for claims
• Review Sequential billing requirements with examples
• NOE exceptions
• Physician Billing
3. Detail Specific Medicare Regulatory Issues affecting Hospice Reimbursement
• Review Hospice Face-to-Face Requirements
• Impact of the Public Health Emergency (PHE)
• Audit Risks – CMS Targeted Probe & Educate
4. List the Target areas for Hospice PEPPER and the use of the data.
• Review criteria that lead to target scores higher than the National numbers
• Review steps agency should take for improvement in scores