Speaker: Melinda A. Gaboury, CEO
About the Speaker
Melinda A. Gaboury, with more than 29 years in home care, has over 20 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 on the NAHC/HHFMA Advisory Board and Work Group and is Treasurer on the Home Care Association of Florida Board of Directors. Melinda is also the author of the Home Health OASIS Guide to OASIS-D1.
About the Event
This conference will provide you with opportunity to network and to learn new ways to tackle your agency’s biggest challenges and increase your knowledge of latest industry trends and initiatives by attending numerous educational activities at the conference. Engage and network with people who do what you do.
Speaker: Melinda A. Gaboury
Wednesday, November 3, 2021 | 11:00AM-12:00PM | The Retiring RAP and the Notice of Admission Named Successor
The most significant change agencies have experienced with billing in 2021 is the timely submission requirement for the Request for Anticipated Payment (RAP) and associated penalty. The coming Notice of Admission (NOA) in 2022 is the next big issue. RAPs have no associated reimbursement in 2021 but carry a monetary penalty if not filed timely and the same will be true for the NOA. The NOA potentially carries a more significant penalty punch and agencies must be prepared. This session will review some of the key areas of concern with both and guide agencies to compliance.
Wednesday, November 3, 2021 | 1:30PM-2:30PM | Medical Review in the Home Health Medicare Certified World
This session will take agencies through the winding road of Medicare scrutiny. While billing the Medicare benefit and getting paid relatively easy, there is always a risk of things being reviewed at some point and what can you do to avoid denials. Participants will be able to define the levels of Medical Review that are currently active: including, UPIC, SMRC, MAC ADR, RAC and the reinstated Targeted Probe & Educate. The session will review how to respond to any level of medical review that may occur. This session will also discuss PEPPER reports and other data analysis that agencies will need to review to ensure that their risk from medical review is limited. This session will review some State specific PEPPER data so you can tell where you stand compared to others in the state. Don’t be caught in the position of believing that everything is just okay or that the Public Health Emergency is a shield from medical review. Attendees will take away information that will assist in assuring that your home health truly is accurately documenting.