Home Health Reimbursement Workshop

This workshop will take agencies through the significant updates to the PDGM reimbursement model and move through all the aspects of home health reimbursement. PDGM has brought many changes to home health and 2022 will see even more changes to the model. In addition to working through the fine details of PDGM changes the workshop will also cover 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.  In addition to Traditional Medicare, the Medicare Advantage plans have become a major part of home health reimbursement and this workshop will take you through some of the detail aspects of getting what you need in order to get paid.  Medical Review has emerged as one of the greatest concerns for home health.  This workshop will take you through the contractor asks and dig into the reasons behind review.  PEPPER reports are a large part of the data used to target agencies and this workshop will give you an up to date review of how to analyze your current PEPPER.  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 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. Details of Billing RAP & Final Claim
6. OASIS & Coding Impact on Reimbursement
7. Detail Credentialing with Managed Care & Issues surrounding getting paid
8. Medical Review – all contractors
9. PEPPER Reports – monitoring and evaluating


Melinda A. Gaboury, COS-C, CEO - Healthcare Provider Solutions

See Program For Details

Continuing Education:

This activity is eligible for 6 nurse contact hours.
The Association for Home & Hospice Care of North Carolina is approved as a provider of nursing continuing professional development by the North Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. Approval for providing Continuing Competence for Physical Therapists and Physical Therapist Assistants is currently pending.

Confirmation: Prior to the webinar, you will receive a Zoom confirmation email which will include a join link to access the webinar, a dial-in number and an access code to listen in via telephone. You will also be sent any pertinent handouts if available.

Registration Fee: The registration fee covers one individual and one continuing education (CE) certificate (if applicable). Multiple site participation from individuals within your agency will require separate registration. For example: if your agency has paid for 1 participating registration but 3 people from your agency would like to attend (and receive CE credit), your agency will need to pay a separate registration fee for all 3 participants. In addition, if your agency has sent in 1 registration but 3 people from your agency register through the Zoom link, your agency will be invoiced the registration fee for the additional 2 registrations. The handouts will be emailed to you to the email address you provide. Please feel free to provide an additional email address as a backup. If you would like to register more than 10 attendees from your agency, please contact [email protected] for discount group pricing.

Cancellation and Substitution Policy: Fees will be refunded, or invoices will be adjusted, only if written notice of cancellation is received by AHHC one week prior to the event. In the event of cancellation, AHHC will retain, or charge, 50% of the initial registration fee, per registrant, to cover administrative overhead. Once written cancellation is received, an AHHC staff member will review for approval. If your cancellation is approved, we will email back a signed and dated copy of the cancellation that your agency should retain on file in case of questions. Substitutions may be made up to the day of the event. Please contact [email protected] if you have any questions. 

1/19/2022 9:00 AM - 4:00 PM
Eastern Standard Time

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