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Medicare Home Health Reimbursement: PDGM & Beyond

  • Tuesday, June 02, 2020
  • Wednesday, June 03, 2020
  • 2 sessions
  • Tuesday, June 02, 2020, 9:00 AM 4:00 PM (EDT)
  • Wednesday, June 03, 2020, 9:00 AM 4:00 PM (EDT)
  • Webinar

Registration


Registration is closed

Virtual Workshop Overview

 This two-day virtual workshop will take agencies through the current state of PDGM and move through all the aspects of home health reimbursement.  PDGM has brought many changes to home health and PDGM is not all that reimbursement is made up of.  In addition to working through the fine details of PDGM changes the workshop will also cover extensive examples for LUPA, PEP and Outlier adjustments.  There will be a discussion of Pre-Bill claim reviews and the significance of that.  The impact of OASIS & Coding and medical review programs have the potential to more directly impact reimbursement than some of the other aspects of PDGM and this workshop will get you up to date on all that.  Cash flow has been one of the gravest areas of concern in recent months….let us take you through the basics of cash flow projections and how best to make that work in your organization.  Whether you are a biller, collector or Administrator, this workshop is just what is needed to get you up to date on all things Home Health Reimbursement.

 Program Goals:

    Day 1:  Day to Day Revenue Cycle Under PDGM

  1. Evaluate the PDGM Structure
  2. Detail the significant impact of Intake on Revenue Cycle
  3. HIPPS Code & Episode Exceptions Review
  4. LUPA, PEP & Outlier Calculations
  5. Describe the process for effectively auditing a Chart for purposes of identifying prebill issues, including NonRoutine Supplies
  6. Details of Billing RAP & Final Claim
  7. OASIS & Coding Impact on Reimbursement

    Day 2:  Home Health Reimbursement: Beyond PDGM

  1. OASIS & Coding
  2. Medicare Secondary Payer
  3. Detail Credentialing with Managed Care & Issues surrounding getting paid
  4. Establish processes for effectively monitoring ADR/RA & UPIC reviews
  5. Targeted Probe & Educate
  6. PEPPER Reports – monitoring and evaluating


About the Presenter


Melinda Gaboury is co-founder and Chief Executive Officer of Healthcare Provider Solutions, Inc., an organization out of Nashville, TN that provides financial, reimbursement, clinical and operation services to the home health and hospice industries.  With more than 27 years of experience in Medicare Home Health, she is a presenter at both the state and national levels, and is interviewed frequently for national home health publications.  Ms. Gaboury is also the author of "Home Health Guide to OASIS D: A Reference for Field Staff."  Ms. Gaboury has no conflict of interest in regard to this program.

PLEASE NOTE: Webinar log-in information and instructions will be emailed to you from the OCHCH directly before the program.


The program is offered by the Ohio Council for Home Care and Hospice.


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