Joe Russell, executive director for OCHCH said “We’re no longer going to wait for others to act. We are placing the future in our hands. We’ve put a lot of time and energy into finding resolutions for our members, and I’m so very excited to announce the creation of the OCHCH managed care network, called the Ohio Community at Home Network, or OCHN.” OCHCH will be traveling around the state throughout the month of February to explain how the network will operate and allow home health and hospice agencies the opportunity to join the network ahead of the official March launch. “OCHN will begin offering the network to Medicaid, Medicare Advantage, and commercial managed care plans shortly after the March launch,” Russell said. The network’s strength and appeal with commercial payors and managed care plans will continually grow as more members participate in OCHN, and when statewide coverage is achieved. OCHCH asks that members attend one of regional informational events even if they are unsure about participating in the network.

OCHCH is proud to partner with the Minnesota HomeCare Association to bring you this webinar. Medicare Advantage Plans may or may not have changes in 2020 in regard to PDGM. Medicare Advantage Plans that pay agencies episodically will eventually convert to RAPs and Finals being required every 30 days instead of 60.  This webinar will cover details regarding the actual billing changes that will need to occur under PDGM. This webinar will discuss the ins and outs of dealing with Medicare Advantage plans, including authorizations, codes for claims and dealing with intermediaries when trying to get paid by Medicare Advantage Plans. Program Objectives:

1. Detail the changes to the billing process under PDGM for Medicare Advantage.
2. Detail the specifics of successfully collecting under the Medicare Advantage program.
3. Review the process from Intake through to billing for successful Medicare Advantage billing and collections.

With the implementation of PDGM, many have experienced new issues.

1. When your patient transfers into a facility, which OASIS do you complete and is it a SOC or a ROC you complete when they come back?
2. What if the patient is still in that facility as the new payment period starts?
3. What is the new process for OASIS DC?
4. Is there a requirement for updating for new diagnoses, changed diagnoses, and resolved diagnoses for a new payment period even if there isn’t an OASIS?
5. What changes in diagnosis coding will improve your opportunities for success in PDGM?