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CAHSAH Medicare Hospice Reimbursement Workshop

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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CAHSAH Medicare Hospice Reimbursement Workshop Mar 07
9:00 am - 4:00 pm PST
Hosted by

About the Event

Program Agenda
9:00 am – 12:00 pm: Workshop
12:00 pm – 1:00 pm: Lunch (provided)
1:00 pm – 4:00 pm: Workshop

Workshop Description
Changes to the Medicare Hospice Regulations have occurred over the past few years and continue.  Is your hospice thriving?  Do you know where your agency stands with the PEPPER targets?  Has the Value Based Insurance Design model (VBID) impacted your hospice?

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 2024 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.

Program Topics:

  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
  1. Detail criteria for billing Hospice Notice of Election and Claims to Medicare
    • Review the requirements of the Election Statement Addendum
    • Review Sequential billing requirements with
  1. Detail Specific Medicare Regulatory Issues affecting Hospice Reimbursement
    • Review Hospice Face-to-Face Requirements
    • Audit Risks – CMS Targeted Probe & Educate, SMRC, UPIC & RAC
    • Special Focus Program review
  1. 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