RCD - Review Choice Demonstration - Training for Texas CHHAs


[3250] RCD - Review Choice Demonstration - Training for TX CHHAs
An on-demand, rich-media recording of the June 19, 2019 RCD Training Event in San Antonio.

NOW AVAILABLE - RELEASED 06/24/2019 This training program was presented on 06/19/2019 at the TAHC&H / Palmetto GBA RCD Training Event in San Antonio.

TAHC & HCIN must comply with a PALMETTO GBA requirement to limit the availability of the Palmetto GBA presenter-specific recorded presentations (Part One/2 Hrs).

EFFECTIVE JULY 5TH Part Two of this recorded RCD LiveStream will be available separately. The Illinois RCD Experience: Preclaim Review Success can be ordered HERE.

Presentation Info:

  • Presentation Date: June 19, 2019
  • TAHC&H Event: RCD - Review Choice Demonstration Training | San Antonio

Education-Training Credits:

  • TX HCSSA Administrator/Alternate Continuing Education
    • 4.0 Clock Hrs
  • Continuing Education for Nurses
    • 4.0 Contact Hr(s)
    • This program awards CNE until 06/19/2021

CE Approval Statements:
· This program meets continuing education requirements for Administrators and Alternates under Texas HCSSA licensing regulations.
· Texas Association for Home Care & Hospice is an approved provider of continuing nursing education by the Texas Nurses Association - Approver, an accredited approver with distinction by the American Nurses Credentialing Center’s Commission on Accreditation.

HCSSA Topic(s) Addressed:

  • §97.259[d][4]agency responsibilities
  • §97.260[a][6]risk assessment and management
  • §97.260[a][7]financial management

Program Description: Home Health Providers in Illinois, North Carolina, Ohio, Florida or Texas are gearing up for the implementation of the Review Choice Demonstration (RCD) in their states.

TAHC&H is here to ensure you get the top tier education you need to be successful. We have partnered with Palmetto GBA and two Illinois providers to bring you this informative training. During this presentation, Tammy Tucci will focus on the RCD program and selection process through the eService portal. She will discuss in detail the initial review and subsequent review choices. CJ Sims will follow presenting the clinical side of the Home Health benefit and what Palmetto GBA is looking for when submitting a Pre Claim Review (PCR). Finally, two providers from Illinois will wrap up the training session with practical tips and tested processes to help you be successful with RCD.

RCD Goals

  • Assist CMS in developing improved methods to identify, investigate, and prosecute potential fraud
  • Protect the Medicare Trust Fund
  • Reduce the rate of improper payments
  • Improve provider compliance with Medicare rules and requirements
  • Offers providers increased flexibility and choice
  • Risk-based changes to reward providers who show compliance with policies

Program Learning Outcome:

  • Participants will actively engage in the learning activity and indicate an intent to change their practice by effectively managing the Review Choice Demonstration process and ensuring appropriate clinical documentation thereby decreasing the number of non-affirmations related to poor or insufficient documentation.

TAHC&H Faculty/Presenters: Tammy Tucci, Manager, Provider Outreach & Education, Palmetto GBA | CJ Sims, Senior Provider Education Consultant, Provider Outreach & Education, Palmetto GBA | Cheryl Adams, RN, BSN, MBA, Administrator, At-Home Health Care of Sparta Community Hospital and President, Illinois Homecare & Hospice Council | Sheila Guither, MSN, RN, CWOCN, COS-C. OSF Home Care Services and Past President, Illinois Homecare & Hospice Council

About the Presenters:
Tammy Tucci began her employment with Palmetto GBA in 1998. She has spent her entire nineteen (21) year tenure with Palmetto GBA in various positions in the Provider Outreach and Education (POE) department. She is currently the manager of the department for the Jurisdiction M (JM) and Jurisdiction J (JJ) contracts based out of her home in Gilbert, SC. In addition to her management duties, she travels the sixteen (16) states in JM as well as the three states in JJ educating providers on Medicare Part A, Part B and Home Health and Hospice coverage and billing guidelines.

“CJ” Cordelia Sims is a Senior Provider Education Consultant at Palmetto GBA. She has worked in various clinical settings such as, doctor’s offices, Medical Surgical, ER, Post-Partum, as well as Home health and ALF to also include Community Compliance Coordinator for an ALF. With over 18 years in the nursing field, CJ began her career with the Commercial side of BCBS in 2016 with Provider Relations. She enjoyed working in all of the lines of business before transitioning to the Provider Outreach and Education Team.

Sheila Guither MSN RN, CWOCN, COS-C currently serves as Immediate Past President of the Illinois Home Care and Hospice Council. She works as the Manager of Clinical Practice and Staff Development for OSF Healthcare- Home Care and Post-Acute Services in Peoria, IL. Throughout the Illinois Preclaim Review demonstration, OSF achieved a 100% affirmation rate without compromising access to care. Sheila earned her Master’s Degree in Nursing Education from OSF Saint Francis College of Nursing, her BSN from Mennonite College of Nursing in Bloomington, IL and her Wound, Ostomy, and Continence Nurse (WOCN) certification from Emory University in Atlanta, GA. She has worked in the Home Care field for 23 years serving in various clinical and leadership roles. She resides in Bloomington, IL with her husband and three children.

Cheryl Adams RN, BSN, MBA with 40 years of clinical nursing and healthcare executive experience. Cheryl has been the administrator of At-Home Health Care of Sparta Community Hospital since its inception in 1996. Cheryl is responsible for developing, implementing and sustaining the business plan for the hospital based home health agency known as At-Home Health Care. The agency under her direction has a history of multiple deficiency free surveys, a reduction in acute care hospitalization rate, improved patient satisfaction and implementation of a telehealth program. Cheryl is credentialed as a Home Health ICD-10 Coder and OASIS Specialist. Cheryl is committed to having a voice for the home care industry and the people that are served. She feels it is important that leaders of home care ensure access to care but also quality of care to those we serve all while staying compliant with rules and regulations of home health. With the implementation of the pilot program of Pre-claim Review in IL, Cheryl has succeeded in achieving a 100% affirmation rate through the education and implementation of processes to ensure accurate, complete documentation.

[3250] RCD - Review Choice Demonstration - Training for TX CHHAs

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