Healthcare Provider Solutions
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Virtual Medicare PDGM Workshop

Description:

This two-day workshop will take agencies through the current state of the Patient-Driven Groupings Model (PDGM) and move through all the aspects of Medicare home health reimbursement.

Day 1 Virtual Medicare PDGM Workshop

The PDGM has brought many changes to home health and the PDGM is not all that reimbursement is made up of. In addition to working through the fine details of the PDGM changes, the workshop will also cover extensive examples for Low Utilization Payment Adjustments (LUPAs), Partial Episode Payments (PEPs), and outlier adjustments. There will be a discussion of pre-billing claim reviews and the significance of them.

Day-to-Day Revenue Cycle Under the Patient-Driven Groupings Model with COVID-19 Updates
• Evaluate the PDGM Structure
• Detail the significant impact of intake on revenue cycle
• Health Insurance Prospective Payment System (HIPPS) code and episode exceptions review
• LUPA, PEP, and outlier calculations
• Describe the process for effectively auditing a chart for purposes of identifying pre-bill issues, including non-routine supplies
• Details of billing Requests for Anticipated Payment (RAPs) and final claims
• OASIS and ICD-10 coding impact on reimbursement


Day 2 Virtual Medicare PDGM Workshop

The impact of OASIS, ICD-10 coding, and medical review programs have the potential to more directly impact reimbursement than some of the other aspects of the PDGM, and this workshop will get you up to date on all of that as well. Additionally, with cash flow being one of the gravest areas of concern for providers in recent months, this workshop will take you through the basics of cash flow projections and how best to make that work in your organization.

Home Health Reimbursement: Beyond the PDGM with COVID-19 Updates
* OASIS and ICD-10 coding
* Medicare secondary payer
* Detail credentialing with managed care and issues surrounding getting paid
* Establish processes for effectively monitoring ADR/Recovery Audit (RA), and Unified Program Integrity Contractor (UPIC) reviews
* Monitoring and evaluating your Program for Evaluating Payment Patterns Electronic Report (PEPPER)
* Factoring the Review Choice Demonstration into the PDGM

Event Type:
When:
June 8 - June 9
Where:
Webinar
Speaker:
Melinda A. Gaboury, CEO
Hosted By:
OCHCH
Registration:

Become an HPS Alliance Member!

 

The HPS Alliance is a Membership-based Home Care and Hospice Educational Resource.

Healthcare Provider Solutions is dedicated to providing our clients with industry leading education in order to keep you informed, educated, and performing at the highest level of success.

We provide online education through our HPS Alliance. Our annual membership provides members with the education necessary to establish and maintain a successful agency. Our mission at HPS is to provide the highest quality of products and services to healthcare providers enabling them to maximize their operations potential and enhance reimbursement.

 

 

  • Six ninety minute Home Care webinars taught by Melinda A. Gaboury, CEO
  • Six ninety minute Hospice webinars taught by Leslie Heagy, RN, COS-C
  • Two-day Home Care Medicare Compliance/Reimbursement workshop taught by Melinda A. Gaboury, CEO
  • Two-day Hospice Medicare Compliance/Reimbursement workshop taught by Leslie Heagy, RN, COS-C
  • Full access to the Home Care and Hospice Compliance & Reimbursement training video series (updated annually to include the latest regulatory changes)
  • Immediate access to our Home Health & Hospice Audit Tools plus many more Alliance only resources
  • Consulting support from our staff via the Alliance member portal
  • Critical updates affecting the Home Care and Hospice community delivered via our website, social media, and email
  • 10% off hourly consultation services with our team of seasoned professionals
$399/Annually

*All Alliance workshops are held in Nashville, TN.

*Access all videos and recordings from the Alliance member dashboard.