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Speaker(s): Melinda A. Gaboury, CEO & Victoria Barron, MBA, BSN, RN, COS-C
About the Speaker(s)
Melinda A. Gaboury, with more than 30 years in home care, 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 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 as the Chair of the NAHC/HHFMA Advisory Board and Work Group and is currently serving on the Board of Directors for both the Home Care Association of Florida & Tennessee Association for Home Care. Melinda is also the author of the Home Health OASIS Guide to OASIS-E and Home Health Billing Answers, 2023.
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About the Event
2:45 – 4:15pm CST
Coming From Every Angle: Dealing with Home Health Medical Review
Speaker: Melinda A. Gaboury, COS-C
Home Health is under a high level of medical review scrutiny, resulting in increased requests for patient charts to be reviewed. It seems the review contractor list keeps growing: Targeted Probe and Educate, SMRC, RAC or UPIC audits. All home health agencies must be prepared to respond to ADRs with documentation that supports ongoing medical necessity and clearly meets regulatory guidelines, including homebound status. This session will provide guidance and examples to ensure your agency is prepared to respond to any medical review request and best practices for avoiding denials.
Texas High Risk Hospices Under PPEO: Preparing for Audit
Speaker: Victoria Barron, MBA, BSN, RN, COS-C
With 48% of Texas hospices who were selected for Provisional Period of Enhanced Oversight (PPEO) ADRs falling into the major risk category for subsequent audit probes, it is critical for hospices to understand the medical review audit and appeals process, top denial risks and regulatory requirements to succeed under medical review and avoid subsequent audits. This session will address the various types of hospice medical review audits, top denial reasons, discuss the appeals process, and provide guidance, tips and examples to ensure your agency is prepared to respond to ADRs for positive outcomes.