RCD: Clinical & Billing Perspectives


[3466] RCD: Clinical & Billing Perspectives
Operationalizing the RAP 2021 and Lessons Learned from PCR

Presentation Info:

  • TAHC&H Virtual Event | Administrator Program | Recorded for On-Demand Access
  • Presentation Date | November 19, 2020

Education-Training Credits:

  • TX HCSSA Administrator/Alternate Continuing Education
    • 1.5 Clock Hr(s)
  • Continuing Education for Nurses
    • 1.5 Contact Hr(s)
    • This program awards CNE until 11.19.2022

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 Louisiana State Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. LSNA Provider No. 4002151

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

Program Description: The RAP will not provide any payment to agencies beginning January 1, 2021, but agencies may be paying CMS if late. The requirements are not the same, but certain elements leave agency leaders scratching their heads. Lisa and Petria present the new requirements and how agencies can operationalize the new RAP in a timely manner and still reconcile their accounts receivables. Face to Face encounter documentation has been the biggest hurdle in PCR, especially with the diagnosis related to the encounter aspect. Lisa and Petria provide pointers for processing the PCR that will assist in better documentation, and therefore a higher affirmation rate.

Program Learning Outcome: Participants will actively engage in the learning activity and apply the new requirements to their daily practice to improve agency operational processes and higher affirmation rates.

TAHC&H Faculty/Presenter(s): Lisa Selman-Holman, President, Selman-Holman & Associates, A Briggs Healthcare Company | Petria McKelvey, CEO, Precision Medical Billing

About the Presenter(s):
Lisa Selman-Holman
is a veteran of home care with over 30 years spent in home health and hospice, both as an RN and as an attorney practicing exclusively in home care. She is the President of Selman-Holman & Associates, A Briggs Healthcare Company, a full-service home care and hospice consulting firm; CoDR (Coding Done Right), an outsourcing company for home care and hospice coding and OASIS review; and Code Pro U, the premier comprehensive online education for ICD-10-CM and OASIS.

Petria McKelvey is CEO and Founder of PMB, with 30 years of experience in the medical billing industry. Petria's expertise runs wide and deep. She has helped hundreds of private practitioners and healthcare organizations solve their billing challenges and recover millions of dollars in lost revenues. She personally has performed over 1000 audits.

[3466] RCD: Clinical & Billing Perspectives

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