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This two-day workshop will cover what you need to know now to be effective with Medicare PPS billing and help prepare your agency for the implementation of the Patient-Driven Groupings Model (PDGM).
Speaker: CEO, Melinda A. Gaboury
Tuesday, June 4, 2019 | 2019 Home Health Reimbursement Under PPS
Home Health billers and collectors are extremely important to agencies thriving in the current challenging environment! Directors,
Managers and Supervisors must also know the Medicare HH billing requirements as key players in the agency’s financial success and
survival. Be the first to be current on all Medicare billing regulations for 2019. If you are part of the revenue cycle in your agency this
workshop is a must.
This workshop will lay a strong foundation for your home health staff by providing a more effective approach to the Medicare PPS
regulation requirements. She will discuss Medicare patient verification, adjacent episode calculations, details - field by field on claim
forms and billing updates. We will present on how to effectively audit a pre-bill for final claim purposes, both Medicare and Non-
Medicare Payers, and review the details of billing for Non-Routine Supplies using billing guidelines.
As we all know, more and more scrutiny of agency records has been taking place in the form or ADR and RAC reviews. This session
will outline the current risks and outline steps to manage that risk and include how to utilize PEPPER report data as a risk management
Wednesday, June 5, 2019 | Patient-Driven Groupings Model
The Patient Driven Groupings Model (PDGM) will go into effect January 1, 2020. This is the most massive change to the home care
industry reimbursement structure since the introduction of the current Prospective Payment System (PPS) in October 2000. The new
payment model dramatically impacts agency operations, processes and performance. Agencies must develop and implement plans
to successfully transition to PDGM. This workshop will discuss key areas, strategies and processes in preparing an agency for PDGM.
This workshop will have a focus on best episode management and process improvement practices including the referral, intake and
scheduling processes, timely documentation, physician and patient communication strategies, all of which are required to more tightly
manage care within the shorter 30-day payment period. The change to a 30-day payment model will also bring significant back office
changes, specific to the claims processing and collections, which will be one emphasis of this workshop. A strong clinical episode
management program is critical to ensure sustained, efficient, cost-effective and uncompromised quality care delivery under the PDGM
program! This workshop will bring emphasis to the fact that every discipline is valued the same and extra therapy visits does not equal
higher payment. Lastly, this workshop will review the full blown emphasis of ICD-10 coding under PDGM and how agencies will have to
monitor to ensure the specificity of coding for their patient care plans.
- Melinda A. Gaboury, CEO
- Hosted By:
- Ohio Council for Home Care & Hospice