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? 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 requirements.
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 HQRP & CAP information and how hospices can work toward improvement outcomes. If you play any part in the responsibility of reimbursement in your hospice this workshop is a must.
January 20 – 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
- Highlight Claims Processing Issues
10:00 – 10:30 Break
January 20 – 10:30 – 12:00 Session 2 – Hospice Election Addendum, Certification & Face to Face Encounters
- Detail criteria for billing Hospice Election Statement and Claims to Medicare
- Review the requirements of the Election Statement Addendum
- Review Hospice Face-to-Face Requirements
- Review Certificate of Terminal Illness details
January 21 – 8:30 – 10:00 Session 1 – Hospice Medical Review & Special Focus Program
- Detail Specific Medicare Regulatory Issues affecting Hospice Reimbursement
- Audit Risks – CMS Targeted Probe & Educate, SMRC, UPIC & RAC
- Best Practices for dealing with Medical Review
- Special Focus Program Details
10:00 – 10:30 Break
January 21 – 10:30 – 12:00 Session 2 – Hospice Quality Reporting Program & Hospice CAP
- List the data from claims used in the Hospice Quality Reporting Program (HQRP) & CAP
- Review details of HQRP Compliance including details of the Hospice Care Index and how data from claims is used
- Detail Claim codes that could impact decisions on Medical Review
- Highlight CAP calculation and how agency self-report must be filed soon