Description

This program will take agencies through the winding road of Medicare scrutiny. While billing the Medicare benefit and getting paid is relatively easy, there is always a risk of things being reviewed at some point. You need to know what you can do to avoid denials.

Participants will be able to define the different levels of medical review and outline the structure of how to respond to any level of medical review that may occur. This session will also discuss PEPPER reports and other data analysis that agencies will need to review to ensure that their risk from medical review is limited.

We will review the Top 5 Medical Review Denial reasons and how to avoid them. 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.

Our Speaker

Melinda A. Gaboury, COS-C, Chief Executive Officer, Healthcare Provider Solutions

Melinda A. Gaboury, with more than 30 years in home care, has over 22 years of executive speaking and educating experience, including extensive day to day interaction with home care and hospice professionals. She routinely conducts Home Care and Hospice Reimbursement Workshops and speaks at state association meetings throughout the country. Melinda has profound experience in Medicare PDGM training, billing, collections, case-mix calculations, chart reviews and due diligence. UPIC, RA, ADR & TPE appeals with all Medicare MACs have become the forefront of Melinda’s current impact on the industry. She is currently serving as Chair of NAHC/HHFMA Advisory Board and Work Group and serves on the Board of Directors for both the Home Care Association of Florida and the Tennessee Association for Home Care. Melinda is also the author of the Home Health OASIS Guide to OASIS-E and Home Health Billing Answers, 2023.