EVENTS
AHHCNC Home Health Reimbursement Workshop – Day 1
Speaker(s): Melinda A. Gaboury, CEO
Category: Home Care
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
January 2025 brings even more changes with the updates to the Value-Based Purchasing Expansion. Agencies must develop and implement plans to continue to succeed under the current reimbursement model, PDGM. This workshop will discuss key areas, strategies and processes in assisting an agency with continued success in 2025. This workshop will have a focus on best episode management and process improvement practices including the referral, intake and scheduling processes, timely documentation, physician and patient communication strategies, all of which are required to more tightly manage care within the 30-day payment period. The data utilized in determining impact of medical review and top denials resulting from medical review will be detailed. Lastly, the workshop will include a session on being successful with Medicare Advantage contracting and implementation.
January 14, 2025
Time: 8:30am – 12:00pm
8:30 – 10:00 Session 1 – Key Revenue Cycle Elements Related to PDGM
Summarize key Revenue Cycle Operations affected by PDGM
- Discuss necessary modifications to the intake and referral process under PDGM
- Outline the Impact on case-mix weight with coding and OASIS
- Present data to assist in determining financial impacts of PDGM on an agency
- Explain scheduling strategies to prevent penalties for Late NOAs
10:00 – 10:30 Break
10:30 – 12:00 Session 2 – Home Health Medical Review & Avoiding Denials
Review the Specifics of Data Resulting in Medical Review
- Detail the impact of claims data on medical review
- Discuss top 5 reasons for Medical Review Denials
- Outline best practices for avoiding medical review denials
January 22, 2025
Time: 8:30am – 12:00pm
8:30 – 10:00 Session 1 – Medicare Advantage Success 2025 & Forward
Review the details of Medicare Advantage Success
- Provide Detail statistics on where Medicare Advantage is active
- Planning for strategic and longer-term sustainability in partnering with MA Plans.
- Evaluate steps in contracting with Medicare Advantage Plans
10:00 – 10:30 Break
10:30 – 12:00 Session 2 – Home Health Value Based Purchasing Model
Detail 2025 Home Health Value Based Purchasing Expansion & Reports
- Outline HHVBP Model for 2025
- Detail Impact of payment adjustments from 2023 data
- Review Interim Performance Reports details