About the Event

Speaker: CEO, Melinda A. Gaboury
Medical Review in the Hospice Medicare Certified World | Tuesday, May 18, 2021 | 10:30am -11:30am CST

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, and RAC. 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 Tennessee specific PEPPER data so you can tell where you stand compared to others in the state. Do not 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 hospice truly is accurately documenting.

Hospice Eligibility Documentation | Tuesday, May 18, 2021 | 12:30pm-1:30pm CST

Accurate hospice eligibility documentation is critical to fulfilling the CoPs and payment requirements. The lack of supporting documentation for a terminal prognosis is the number one reason for denial. Reviewers often look for a significant decline in patient condition. Although this is not a requirement of hospice care, terminal prognosis is. The session will help clinicians document the slightest changes in baseline measures. More importantly, you’ll learn how to capture in documentation the occurring changes that support terminal prognosis – even without a decline in baseline measures. Go beyond the LCDs and common tools for documenting eligibility by drilling down to the details and characteristics that differentiate terminal and chronic patients with the same diagnosis. This session will include the following: • Detail the technical eligibility requirements for hospice; • Outline the documentation requirements for patients to meet hospice eligibility upon election/admission and throughout the course of care; • List the elements that Medicare MACs are not accepting as eligibility supporting documentation & • Document the differences between terminal prognosis and chronic condition.