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HCAF Home Health Billing Webinar Series: Part 4 of 4

Speaker(s): Melinda A. Gaboury, CEO

Category: Home Care

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Speaker(s): Melinda A. Gaboury, CEO

About the Speaker(s)

Melinda A. Gaboury, COS-C, is co-founder and Chief Executive Officer of Healthcare Provider Solutions, Inc. (HPS). Melinda Gaboury and Mark Cannon founded the company in April 2001 to provide financial, reimbursement, billing, coding, operational and clinical consulting to the home care and hospice industries. With more than 30 years in home care, Melinda 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 PPS 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.

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HCAF Home Health Billing Webinar Series: Part 4 of 4 Jan 17
10:00 am - 11:30 am EST
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About the Event

The Patient-Driven Groupings Model (PDGM) went into effect on January 1, 2020. This is the most significant change to the Medicare home health reimbursement structure since the introduction of the Prospective Payment System (PPS) in 2000. The new payment model has dramatically impacted agency operations, processes, and performance.

January 2023 brings even more issues with rate changes for home health and the impending Home Health Value-Based Purchasing (HHVBP) nationwide expansion. This four-part webinar series will discuss key areas, strategies, and processes, in assisting an agency in staying ahead of PDGM-related changes and reimbursement rates. This program will focus on best episode management and process improvement practices including the referral, intake, and scheduling processes, timely documentation, and physician and patient communication strategies — all of which are required to more tightly manage care within the 30-day payment period.

Part 4: Medicare Advantage & Medicare Secondary Payer

The fourth and final part of this four-part series covers the following topics:

  • The credentialing process with Medicare Advantage (MA) plans
  • The most important questions to ask before signing an in-network agreement
  • The impact of MA plans on the Medicare program
  • The most common claim denial reasons and how to work through them
  • The most common roadblocks in getting MA plans to appropriately process and pay claims
  • Details of Medicare Secondary Payer (MSP)
  • Best practices for determining when MSP applies