[3869] Hospice Medical Review | How to Avoid Denials
This presentation will take agencies through the winding road of
Medicare scrutiny.
Presentation Info:
- TAHC&H Event | 55th Annual Conference | Rich-Media Presentation Capture | Online On-Demand Access
- Presentation Date | September 11, 2024
Program Description: Hospice is on the hot bed of Medical Review in 2024. This presentation will take agencies through the winding road of
Medicare scrutiny. While billing the Medicare benefit and getting paid relatively easily, there is always a risk of things being reviewed at some
point and what can you do to avoid denials. Don’t be caught in the comfortable position of believing that everything is okay. You will take away information
that will assist in assuring that your hospice truly is prepared for an call for medical review of their charts. It will review the top 5 medical
review denial reasons and best practices to avoid these denials.
HCSSA Topic(s) Addressed:
- §558.260[a][3]basic principles of management in a licensed health-related setting
- §558.260[a][5]quality improvement
- §558.260[a][6]risk assessment and management
- §558.260[a][7]financial management
Education-Training Credits:
- TX HCSSA Administrator/Alternate Continuing Education
- Continuing Education for Nurses
- 1.0 Contact Hr(s)
- This program awards CNE until 9.11.2026
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.
[3869] Hospice Medical Review | How to Avoid Denials