Gaboury, Melinda

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Hospice Revenue Cycle – Compliance and Efficiency

[3787] Hospice Revenue Cycle – Compliance and Efficiency
An update on the latest billing and payment issues while examining best practices for optimizing revenue cycle management and mitigating compliance risks. Presentation Info: TAHC&H Event 54th Annual Meeting | Rich-Media Presentation Capture | Online On-Demand Access Presentation Date | August 30, 2023 Program Description: An optimized hospice revenue cycle effectively maintains cash flow and minimizes write-offs. The Hospice Revenue Cycle continues to be threatened by new challenges yearly. New compliance/medical review risks constantly emerge and the hospice billing and payment landscape continues to evolve. Recently added complexities created by the expanding Value-Based Insurance Design (VBID) demonstration project and increasing medical review audits from all sides are topped off by heightened scrutiny by the Office of Inspector General (OIG). This presentation provides hospices with an update on the latest billing and payment issues while examining best practices for optimizing revenue cycle management and mitigating compliance risks. HCSSA Topic(s) Addressed: §558.259[d][4]agency responsibilities §558.260[a][2]development and interpretation of agency policies §558.260[a][3]basic principles of management in a licensed health-related setting §558.260[a][7]financial management Education-Training Credits: TX HCSSA Administrator/Alternate Continuing Education 1.0 Clock Hr(s) Texas HCSSA CE Approval Statement
This program meets continuing education requirements for Administrators and Alternates under Texas HCSSA licensing regulations. TAHC&H Faculty/Presenter(s): Melinda Gaboury, COS-C, Chief Executive Officer, Healthcare Provider Solutions, Inc. About the Presenter(s): Melinda A. Gaboury, with more than 28 years in home care, has over 18 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 on the NAHC/HHFMA Advisory Board and Work Group and is Associate Director on the Home Care Association of Florida Board of Directors. Melinda is also the author of the Home Health OASIS Guide to OASIS-D1. [3787] Hospice Revenue Cycle – Compliance and Efficiency

Speaker: Gaboury, Melinda
Model: 3787

$30.00

1.0 Hr

Medicare Advantage: Digging in the Details

[3791] Medicare Advantage: Digging in the Details
This session will assist with details that are needed for success under Medicare Advantage. Presentation Info: TAHC&H Event 54th Annual Meeting | Rich-Media Presentation Capture | Online On-Demand Access Presentation Date | August 31, 2023 Program Description: Home Health providers are grappling with the shift in the Medicare eligible population into Medicare Advantage Plans (MA Plans). Providers are asking: What are the implications of current demographic trends? What operational and financial issues should providers expect as their payer mix shifts to mostly Managed Care? Being successful in this environment of these payer mix changes requires agencies to understand their costs of treating these patients and other impacts on their operations on an individual contract basis. This session assists with details that are needed for success under Medicare Advantage. HCSSA Topic(s) Addressed: §558.259[d][4]agency responsibilities §558.260[a][3]basic principles of management in a licensed health-related setting §558.260[a][7]financial management Education-Training Credits: TX HCSSA Administrator/Alternate Continuing Education 1.0 Clock Hr(s) Continuing Education for Nurses 1.0 Contact Hr(s) This program awards CNE until 08.31.2025 Texas HCSSA CE Approval Statement
This program meets continuing education requirements for Administrators and Alternates under Texas HCSSA licensing regulations. Nurse CE Approval Statement
Texas Association for Home Care & Hospice is an approved provider of continuing nursing education by Louisiana State Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. LSNA Provider No. 4002151 Requirements for Successful Completion
To receive continuing education credits for this online presentation participant must view the entire online presentation, complete an evaluation, and post-test attestation. Reporting of Perceived Bias
Bias, as defined by the American Nurses Credentialing Center’s Commission on Accreditation (ANCC COA/LSNA) is the “tendency or inclination to cause partiality, favoritism, or influence.” Commercial bias may occur when a CNE activity promotes one or more product(s) (drugs, devices, services, software, hardware, etc.). This definition is not all inclusive and participants may use their own interpretation in deciding if a presentation is biased. The ANCC COA is interested in the opinions and perceptions of participants at approved CNE activities, especially in the presence of actual or perceived bias in continuing education. Therefore, ANCC invites participants to access their “ANCC Accreditation Feedback Line” to report any noted bias or conflict of interest in the education activity. The toll free number is 1(866) 262-9730. TAHC&H Faculty/Presenter(s): Melinda Gaboury, COS-C, Chief Executive Officer, Healthcare Provider Solutions, Inc. About the Presenter(s): Melinda A. Gaboury, with more than 28 years in home care, has over 18 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 on the NAHC/HHFMA Advisory Board and Work Group and is Associate Director on the Home Care Association of Florida Board of Directors. Melinda is also the author of the Home Health OASIS Guide to OASIS-D1. [3791] Medicare Advantage: Digging in the Details

Speaker: Gaboury, Melinda
Model: 3791

$30.00

1.0 Hr

Medicare Advantage: Digging In the Details

[3832] Medicare Advantage: Digging In the Details
Covers provider issues with Medicare Advantage Plans. Presentation Info: TAHC&H Event | Winter Conference | Fort Worth | Rich-Media Presentation Capture for Your Online On-Demand Access Presentation Date | February 21, 2024 Presentation Track | Medicare Home Health Program Description: Home Health providers are grappling with the shift in the Medicare eligible population into Medicare Advantage Plans (MA Plans). Providers are asking: What are the implications of current demographic trends? What operational and financial issues should providers expect as their payer mix shifts to mostly Managed Care? Being successful in this environment of these payer mix changes requires agencies to understand their costs of treating these patients and other impacts on their operations on an individual contract basis. HCSSA Topic(s) Addressed: §558.259[d][4]agency responsibilities §558.260[a][3]basic principles of management in a licensed health-related setting §558.260[a][5]quality improvement §558.260[a][7]financial management Education-Training Credits: TX HCSSA Administrator/Alternate Continuing Education 1.25 Clock Hr(s) Continuing Education for Nurses 1.25 Contact Hr(s) This program awards CNE until 02.21.2026 Texas HCSSA CE Approval Statement
This program meets continuing education requirements for Administrators and Alternates under Texas HCSSA licensing regulations. Nurse CE Approval Statement
Texas Association for Home Care & Hospice is an approved provider of continuing nursing education by Louisiana State Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. LSNA Provider No. 4002151 Requirements for Successful Completion
To receive continuing education credits for this online presentation participant must view the entire online presentation, complete an evaluation, and post-test attestation. Reporting of Perceived Bias
Bias, as defined by the American Nurses Credentialing Center’s Commission on Accreditation (ANCC COA/LSNA) is the “tendency or inclination to cause partiality, favoritism, or influence.” Commercial bias may occur when a CNE activity promotes one or more product(s) (drugs, devices, services, software, hardware, etc.). This definition is not all inclusive and participants may use their own interpretation in deciding if a presentation is biased. The ANCC COA is interested in the opinions and perceptions of participants at approved CNE activities, especially in the presence of actual or perceived bias in continuing education. Therefore, ANCC invites participants to access their “ANCC Accreditation Feedback Line” to report any noted bias or conflict of interest in the education activity. The toll free number is 1(866) 262-9730. TAHC&H Faculty/Presenter(s): Melinda Gaboury, COS-C, Chief Executive Officer, Healthcare Provider Solutions, Inc. About the Presenter(s): Melinda A. Gaboury, with more than 28 years in home care, has over 18 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 on the NAHC/HHFMA Advisory Board and Work Group and is Associate Director on the Home Care Association of Florida Board of Directors. Melinda is also the author of the Home Health OASIS Guide to OASIS-D1. [3832] Medicare Advantage: Digging In the Details

Speaker: Gaboury, Melinda
Model: 3832

$37.50

1.25 Hrs

VBID – Hospice 2024 Update

[3843] VBID – Hospice 2024 Update
Details of the Value-Based Insurance Design (VBID) Model – Hospice Benefit Component. Presentation Info: TAHC&H Event | Winter Conference | Fort Worth | Rich-Media Presentation Capture for Your Online On-Demand Access Presentation Date | February 22, 2024 Presentation Track | Medicare Hospice Program Description: This program covers the details of the Value-Based Insurance Design (VBID) Model – Hospice Benefit Component. Medicare Advantage (MA) has long had coverage for home health patients, but there has never been coverage for Hospice under the MA benefit until 2021 when the VBID demonstration began to include Hospice. There have been many changes to the Medicare Advantage Organizations (MAO) participating in 2024 as the demonstration has now been extended through 2030. The differences in coverage for an in-network vs. out-of-network provider will be reviewed and the allowance of MAO plans to force patients to elect IN-NETWORK ONLY. CMS requires that MAOs provide beneficiaries with broad access to the complete original Medicare hospice benefit. This program covers all known aspects of the demonstration and will prepare hospices for the reality that Medicare Advantage is now in the Hospice world to stay. HCSSA Topic(s) Addressed: §558.259[d][4]agency responsibilities §558.260[a][3]basic principles of management in a licensed health-related setting §558.260[a][5]quality improvement §558.260[a][7]financial management Education-Training Credits: TX HCSSA Administrator/Alternate Continuing Education 1.0 Clock Hr(s) Continuing Education for Nurses 1.0 Contact Hr(s) This program awards CNE until 02.22.2026 Texas HCSSA CE Approval Statement
This program meets continuing education requirements for Administrators and Alternates under Texas HCSSA licensing regulations. Nurse CE Approval Statement
Texas Association for Home Care & Hospice is an approved provider of continuing nursing education by Louisiana State Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. LSNA Provider No. 4002151 Requirements for Successful Completion
To receive continuing education credits for this online presentation participant must view the entire online presentation, complete an evaluation, and post-test attestation. Reporting of Perceived Bias
Bias, as defined by the American Nurses Credentialing Center’s Commission on Accreditation (ANCC COA/LSNA) is the “tendency or inclination to cause partiality, favoritism, or influence.” Commercial bias may occur when a CNE activity promotes one or more product(s) (drugs, devices, services, software, hardware, etc.). This definition is not all inclusive and participants may use their own interpretation in deciding if a presentation is biased. The ANCC COA is interested in the opinions and perceptions of participants at approved CNE activities, especially in the presence of actual or perceived bias in continuing education. Therefore, ANCC invites participants to access their “ANCC Accreditation Feedback Line” to report any noted bias or conflict of interest in the education activity. The toll free number is 1(866) 262-9730. TAHC&H Faculty/Presenter(s): Melinda Gaboury, COS-C, Chief Executive Officer, Healthcare Provider Solutions, Inc. About the Presenter(s): Melinda A. Gaboury, with more than 28 years in home care, has over 18 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 on the NAHC/HHFMA Advisory Board and Work Group and is Associate Director on the Home Care Association of Florida Board of Directors. Melinda is also the author of the Home Health OASIS Guide to OASIS-D1. [3843] VBID – Hospice 2024 Update

Speaker: Gaboury, Melinda
Model: 3843

$30.00

1.0 Hr

Hospice Special Focus Program (SFP) & Provisional Period of Enhanced Oversight (PPEO)

[3844] Hospice Special Focus Program (SFP) & Provisional Period of Enhanced Oversight (PPEO)
Reviews the details of both programs and what Hospices can expect. Presentation Info: TAHC&H Event | Winter Conference | Fort Worth | Rich-Media Presentation Capture for Your Online On-Demand Access Presentation Date | February 22, 2024 Presentation Track | Medicare Hospice Program Description: Major scrutiny of the Hospice Benefit is well underway nationwide. This program reviews the details of both programs and what Hospices can expect. The Special Focus Program (SFP), will monitor hospices identified as poor performers based on selected quality indicators. Hospices selected for the SFP will be under additional oversight to enable continuous improvement. This required program includes the development and implementation of enforcement remedies for noncompliant hospice programs, as well as procedures for appealing determinations regarding these remedies. These enforcement actions can be imposed instead of, or in addition to, termination of the hospice program’s participation from the Medicare program. Through the PPEO, new providers or suppliers are subject to prepayment medical reviews designed to address improper billing practices right out of the gate. This program is for newly certified hospices as well as change of ownership and a must-view! HCSSA Topic(s) Addressed: §558.259[d][4]agency responsibilities §558.260[a][3]basic principles of management in a licensed health-related setting §558.260[a][5]quality improvement §558.260[a][7]financial management Education-Training Credits: TX HCSSA Administrator/Alternate Continuing Education 1.25 Clock Hr(s) Continuing Education for Nurses 1.25 Contact Hr(s) This program awards CNE until 02.22.2026 Texas HCSSA CE Approval Statement
This program meets continuing education requirements for Administrators and Alternates under Texas HCSSA licensing regulations. Nurse CE Approval Statement
Texas Association for Home Care & Hospice is an approved provider of continuing nursing education by Louisiana State Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. LSNA Provider No. 4002151 Requirements for Successful Completion
To receive continuing education credits for this online presentation participant must view the entire online presentation, complete an evaluation, and post-test attestation. Reporting of Perceived Bias
Bias, as defined by the American Nurses Credentialing Center’s Commission on Accreditation (ANCC COA/LSNA) is the “tendency or inclination to cause partiality, favoritism, or influence.” Commercial bias may occur when a CNE activity promotes one or more product(s) (drugs, devices, services, software, hardware, etc.). This definition is not all inclusive and participants may use their own interpretation in deciding if a presentation is biased. The ANCC COA is interested in the opinions and perceptions of participants at approved CNE activities, especially in the presence of actual or perceived bias in continuing education. Therefore, ANCC invites participants to access their “ANCC Accreditation Feedback Line” to report any noted bias or conflict of interest in the education activity. The toll free number is 1(866) 262-9730. TAHC&H Faculty/Presenter(s): Melinda Gaboury, COS-C, Chief Executive Officer, Healthcare Provider Solutions, Inc. About the Presenter(s): Melinda A. Gaboury, with more than 28 years in home care, has over 18 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 on the NAHC/HHFMA Advisory Board and Work Group and is Associate Director on the Home Care Association of Florida Board of Directors. Melinda is also the author of the Home Health OASIS Guide to OASIS-D1. [3844] Hospice Special Focus Program (SFP) & Provisional Period of Enhanced Oversight (PPEO)