- This workshop will be virtual!!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. June 8th - 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
- 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
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This a Virtual Workshop Overview: During this workshop, to refresh the student with material aligning with the test plan in preparation for taking the Certified Hospice & Palliative Nursing Assistant (CHPNA) certification examination given by the Hospice & Palliative Credentialing Center (HPCC). Program Objectives:
- Overview of Hospice and Palliative Care Nursing Assistant Practice
- Review Nursing Assistant role in pain and symptom management
- Discuss ethical issues in Hospice and Palliative care
- Discuss the importance of communication with patients, families and care providers
- Review cultural considerations
- Discuss spiritual care, loss and bereavement in hospice care
- Review care at the end of life
- Discuss Nursing Assistant personal and professional development
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Program Overview: Hospice Pepper Webinar 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. This session will discuss PEPPER reports and other data analysis that agencies will need to review to ensure that their risk from medical review is limited. Don’t be caught in the comfortable position of believing that everything is okay. Attendees will take away information that will assist in assuring that your hospice truly is accurately documenting. Learning Objectives: * Outline the targets that are calculated on the PEPPER Reports * Detail the targets and other data from the PEPPER reports that is used to evaluate a hospice’s performance * Detail the top reasons hospices are targeted for medical review that correlate to the PEPPER 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.
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Program Overview: The purpose of this introductory program is to give attendees an up-to-date overview of the operations of a Medicare certified home health agency. The participants will gain knowledge of the Conditions of Participation (CoPs), Medicare Manuals (defines PPS billing requirements, plan of care completion, and skilled, intermittent, homebound, reasonable and necessary care), an overview of survey preparation and process, and the role of clinicians in driving financial results. Individuals will gain an understanding of the role of OASIS and adverse events in agency operations. The Ohio Home Care Program (Medicaid) and PASSPORT will also be discussed. This program offers continuing education credits to RNs, LPNs This program will address:
- Informational links and resources of federal and state governments.
- CoPs and the requirements for survey.
- OASIS, OBQI/OBQM reports used by an agency.
- Fundamentals of HIPPA (Code Sets, Privacy, Security)
- Guidelines for home health eligibility - skilled care/homebound
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Program Description: This program has been developed to assist experienced home health managers to enhance the operational performance of their home health agency. Our introductory Home Care 101 course provides the basics of home care operations. Home Care 201 is the next level. Improving clinical performance and financial management in a Medicare skilled home health agency is the focus of Home Care 201. Essential to improving agency operations is identifying clinical issues that impact performance. This program will provide strategies to refine and improve billing performance as well as explain the important relationship between clinical and financial areas of the agency. This focus is important as the future viability of home care operations will be determined by the agency’s ability to remain current with changing regulations, the ongoing focus on patient outcomes, declining reimbursement, and closer scrutiny by auditors that can lead to denials. Attendees are strongly encouraged to bring to the program a written description of at least one problem that they need to resolve within their agency; the goal is to best serve the individual's purpose for attending the class. Program Objectives:
- Recognize clinical issues impacting performance management
- Discuss how to manage the relationship between clinical and financial areas of the agency to optimize performance in each area
- Identify the challenges and strategies to improve billing performance and reimbursement issues
- Describe how to enhance financial performance through sound financial decisions in order to ensure the future of the agency
- Identify useful data management techniques through the use of dashboards and benchmarking
- Discuss current audit activities and strategies to minimize denials
- Discuss additional current issues impacting home health agency operations
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Program Overview: Change is the name of the coding game. New codes, new tabular list changes, new guidelines and new Coding Clinic interpretations, plus new home health payment changes require us to stay ahead of the game. Increase your knowledge and understanding and gain the expertise your agency needs to survive in this comprehensive two-day intermediate to advanced coding course specific for home care coders. Increase your understanding of the regulatory aspects and ethics of diagnosis coding and utilize lots of examples to increase your skills, proficiency, speed and accuracy in choosing the appropriate ICD-10-CM codes. Attendees will be able to demonstrate proficiency in complex coding scenarios and be ready to tackle home care charts with confidence. We will apply Prospective Payment System reform, known as PDGM, to scenarios so that home health participants will understand payment implications and compliance issues. With government auditors targeting home care, now is the time to ensure that you are coding correctly and protecting your revenue. You MUST have a Current 2020 or 2021 ICD-10-CM Coding Manual for this Virtual Workshop The most current version of ICD-10-CM coding manual is available through Selman-Holman at https://selmanholmanassociateswebstore.mybigcommerce.com/2020-complete-home-health-icd-10-cm-diagnosis-coding-manual/ (follow the links to the bookstore; discount provided in cart) or by calling 214-550-1477 ext. 7 to ensure you receive the 2021 version.
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This class is designed with intermediate coders in mind. We recommend a review of the ICD-10-CM Official Guidelines for Coding and Reporting for 2020, pages 1 -20 of the document found at: https://ahcc.decisionhealth.com/media/1241/icd-10-cm-guidelines-ahcc-2020.pdf prior to the workshop. These pages describe and define the Coding Conventions (Section I.A) & General Coding Guidelines (Section I.B). It is expected that intermediate coders already possess this foundational knowledge as it will not be the focus of this class. Your pre-class efforts will greatly enhance your learning experience. Presenter: Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C, HCS-O, HCS-H, has more than 30 years in home care as a RN and Attorney practicing exclusively in home care. She is the Owner of Selman-Holman & Associates, LLC & CoDR-Coding Done Right. Additionally, Lisa sits on the Home Care Coding Specialist-Diagnosis (HCS-D) national advisory board for the Board of Medical Specialty Coding and Compliance (BMSCC) Board HCS-O for OASIS Competency. -
This will be a virtual workshop Program Overview: Knowing and understanding Hospice Quality Reporting is vital for positive Hospice patient outcomes as well as avoidance of potential negative financial impact. During the workshop we will discuss the evolution of Hospice Quality reporting, current and future Hospice Quality Reporting requirements, ways to make your Hospice Quality program more robust and ways to get buy-in from front line staff as well as leadership in the organization. Who Should Attend: This workshop is designed for anyone who participates in the Hospice quality program which includes staff who are new to Quality, seasoned Quality staff, Quality Team members and Leadership. This workshop will address:
- Review the evolvement of Hospice Quality from voluntary to mandatory reporting
- Review the Hospice Quality Reporting requirements
- Discuss future trends and challenges of Hospice Quality Reporting
- Discuss agency-wide (from front-line staff to leader) ownership of the Quality Program
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THIS WILL BE A VIRTUAL EDUCATION EVENT Description: The purpose of this virtual workshop is to give attendees an up-to-date overview of the operations of a Medicare/Medicaid certified hospice. The participants will gain knowledge of the Conditions of Participation (CoP), describe Medicare certification and licensure, define hospice core services, levels of care, plans of care, notice of election, revocation, discharge and transfer. A brief overview of the billing process for Medicare and Medicaid and the basic elements of cost reporting will also be provided. Who Should Attend: This program is developed for newly certified hospice staff including administration and clinical; new staff of an existing hospice; social workers, and private duty hospice administrators considering becoming Medicare certified. This virtual workshop will address:
- Coverage and services available under the Hospice Medicare Benefit
- Conditions of Participation specific to the Hospice Medicare Benefit
- Coordination of care requirements for the hospice patient in a nursing facility
- Medicare’s billing and reimbursement processes for hospice care
- Hospice program differences between Medicare and Ohio Medicaid
- Strategies for managing hospice patients under a PASSPORT/Waiver service plan
- Operational processes important to hospice care and program management
- Available resources related to hospice care delivery and program management
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THIS WILL BE A VIRTUAL EDUCATION EVENT Description: The purpose of this virtual workshop is to give attendees an up-to-date overview of the operations of a Medicare/Medicaid certified hospice. The participants will gain knowledge of the Conditions of Participation (CoP), describe Medicare certification and licensure, define hospice core services, levels of care, plans of care, notice of election, revocation, discharge and transfer. A brief overview of the billing process for Medicare and Medicaid and the basic elements of cost reporting will also be provided. Who Should Attend: This program is developed for newly certified hospice staff including administration and clinical; new staff of an existing hospice; social workers, and private duty hospice administrators considering becoming Medicare certified. This virtual workshop will address:
- Coverage and services available under the Hospice Medicare Benefit
- Conditions of Participation specific to the Hospice Medicare Benefit
- Coordination of care requirements for the hospice patient in a nursing facility
- Medicare’s billing and reimbursement processes for hospice care
- Hospice program differences between Medicare and Ohio Medicaid
- Strategies for managing hospice patients under a PASSPORT/Waiver service plan
- Operational processes important to hospice care and program management
- Available resources related to hospice care delivery and program management
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This a Virtual Workshop Overview: During this workshop, to refresh the student with material aligning with the test plan in preparation for taking the Certified Hospice & Palliative Nursing Assistant (CHPNA) certification examination given by the Hospice & Palliative Credentialing Center (HPCC). Program Objectives:
- Overview of Hospice and Palliative Care Nursing Assistant Practice
- Review Nursing Assistant role in pain and symptom management
- Discuss ethical issues in Hospice and Palliative care
- Discuss the importance of communication with patients, families and care providers
- Review cultural considerations
- Discuss spiritual care, loss and bereavement in hospice care
- Review care at the end of life
- Discuss Nursing Assistant personal and professional development
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THIS IS A VIRTUAL EDUCATION EVENT Program Description: OCHCH is excited to introduce this new workshop, designed for hospice professionals that are stepping into a management role. This program provides hospice-specific information that helps leaders and managers develop the skills they need to meet the challenges and changes they face in managing successful hospice programs, systems and caregivers. Our introductory Hospice 101 course provides the basics of hospice care operations. Hospice 201 is the next level. This workshop offers suggestions for identifying the clinical issues that impact financial performance, and offers guidance on managing the relationship between the quality, clinical and the financial areas of the agency. We’ll also provide strategies to refine and improve billing performance, reduce denials, improve profitability, and increase quality outcomes. Program Objectives:
- Describe the role of hospice care in population care management.
- Identify current state/ federal legislation and regulations affecting hospice care programs.
- Describe methods to enhance the financial performance of a hospice program.
- Describe how to manage staff performance to enhance agency reputation.
- Identify the challenges and strategies to improve billing performance and reimbursement issues.
- Identify opportunities and challenges posed by new quality reporting requirements for hospice programs.
- Discuss current issues impacting the provision of hospice care in a long term care facility.
- Identify useful operations management techniques through the use of dashboards and benchmarking.
