EVENTS
AHHCNC Hospice Reimbursement Workshop – Day 2
Speaker(s): Melinda A. Gaboury, CEO
Category: Hospice
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
Changes to the Medicare Hospice Regulations have occurred over the past few years and continue. Is your hospice thriving? Has Medical Review been an issue for your focus? How has the Value Based Insurance Design model (VBID) impacted your hospice? Are you affected by the Hospice Cap calculation?
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 and any hospice staff that need a clearer understanding of the Medicare regulations. This workshop will include Medicare Notice of Election and claim forms detail requirements.
The 2025 Claims Requirements will be detailed including a review of the levels of care Hospice rates. The workshop will include the CMS Targeted Probe & Educate details as well as other levels of medical review that are currently active for hospice. The workshop will conclude with analyzing the PEPPER information and how hospices can work toward improvement in their scores. If you play any part in the responsibility of reimbursement in your hospice this workshop is a must.
January 6, 2025
Time: 8:30am – 12:00pm
8:30 – 10:00 Session 1 – Hospice Eligibility & Notice of Election
- List the eligibility requirements for initiating Hospice and billing to Medicare
- Review eligibility requirements for the Hospice Benefit.
- Review Benefit Periods & Eligibility
- Review Notice of Election details
10:00 – 10:30 Break
10:30 – 12:00 Session 2 – Hospice Election Statement & Billing Claims
- Detail criteria for billing Hospice Election Statement and Claims to Medicare
- Review the requirements of the Election Statement & Addendum
- Review Sequential billing requirements
- Review current VBID billing and what happens 1/1/2025
January 8, 2025
Time: 8:30am – 12:00pm
8:30 – 10:00 Session 1 – Hospice Regulatory Requirement & Medical Review
- Detail Specific Medicare Regulatory Issues affecting Hospice Reimbursement
- Review Hospice Face-to-Face Requirements
- Review Certificate of Terminal Illness details
- Audit Risks – CMS Targeted Probe & Educate, SMRC, UPIC & RAC
10:00 – 10:30 Break
10:30 – 12:00 Session 2 – Hospice Quality Reporting Program & Claims Data
- List the most data from claims used in the Hospice Quality Reporting Program (HQRP) and Medical Review decisions.
- Review details of HQRP Compliance including details of the Hospice Care Index and how data is from claims
- List the most recent Target areas for Hospice PEPPER and the use of the data and review steps agency should take for improvement in scores