HCAF Day 1 Virtual Medicare PDGM Workshop
Speaker(s): Melinda A. Gaboury, CEO
Category: Speaking Engagement
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8:00 am - 3:00 pm CST Hosted by
About the Event
This two-day workshop will take agencies through the current state of the Patient-Driven Groupings Model (PDGM) and move through all the aspects of Medicare home health reimbursement.
The PDGM has brought many changes to home health and the PDGM is not all that reimbursement is made up of. In addition to working through the fine details of the PDGM changes, the workshop will also cover extensive examples for Low Utilization Payment Adjustments (LUPAs), Partial Episode Payments (PEPs), and outlier adjustments. There will be a discussion of pre-billing claim reviews and the significance of them.
Speaker: Melinda A. Gaboury, CEO | 8:00AM -3:00PM CST!
Day 1 : Day-to-Day Revenue Cycle Under the Patient-Driven Groupings Model with COVID-19 Updates
• Evaluate the PDGM Structure
• Detail the significant impact of intake on revenue cycle
• Health Insurance Prospective Payment System (HIPPS) code and episode exceptions review
• LUPA, PEP, and outlier calculations
• Describe the process for effectively auditing a chart for purposes of identifying pre-bill issues, including non-routine supplies
• Details of billing Requests for Anticipated Payment (RAPs) and final claims
• OASIS and ICD-10 coding impact on reimbursement