Be among the elite group of hospice professionals that are current on all Hospice Medicare reimbursement related regulations. This workshop will lay a concrete foundation for hospice billers, as well as, any hospice staff that need to more effectively understand the Medicare regulations. This workshop will include Medicare verifications with HIQA/HETS screen examples, field by field on Notice of Election and claim forms and sequential billing requirements. The 2019/20 Claims Requirements will be detailed including a review of the new Routine & other levels of Hospice rates will be conducted. The workshop will detail the CMS Targeted Probe & Educate initiative while also reviewing the regulations for face-to-face encounters and pre-claim reviews that should be conducted prior to filing claims. The workshop will conclude with many analyzing the PEPPER information and how hospices can work toward improvement in their scores. If you are play any part in the responsibility of reimbursement in your hospice this workshop is a must.
1. List the basic eligibility requirements for initiating Hospice and Billing to Medicare
• Conduct overview of eligibility requirements for the Hospice Benefit.
• Review Benefit Periods & Eligibility
• Review Notice of Election details
2. Detail criteria for line item billing Hospice Notice of Election and Claims to Medicare
• Review line item requirements including 15-minute increments for claims
• Review Sequential billing requirements with examples
• Pre-Bill Audit Tool Review
3. Detail Specific Medicare Regulatory Issues affecting Hospice Reimbursement
• Review Hospice Face-to-Face Requirements
• Audit Risks – CMS Targeted Probe & Educate
• Review effect of PEPPER Reports on Medicare Review
4. List the Target areas for Hospice PEPPER and the use of the data.
• Review criteria that lead to target scores higher than the National numbers
• Review steps agency should take for improvement in scores
Speaker: Melinda Gaboury is CEO of Healthcare Provider Solutions, which provides financial, reimbursement, clinical and cost reporting services to the home care, hospice and rehabilitation therapy industries. Prior to the inception of Medicare PPS, she began researching, auditing and reviewing processes with OASIS, ICD-10 Coding and clinical documentation. She has developed and taught clinician and billing Medicare PPS trainings in a variety of venues.