Description

The Patient-Driven Groupings Model (PDGM) went into effect on January 1, 2020. This is the most significant change to the Medicare home health reimbursement structure since the introduction of the Prospective Payment System (PPS) in 2000. The new payment model has dramatically impacted agency operations, processes, and performance. 

January 2023 brings even more issues with rate changes for home health and the impending Home Health Value-Based Purchasing (HHVBP) nationwide expansion. This four-part webinar series will discuss key areas, strategies, and processes in assisting an agency in staying ahead of PDGM-related changes and reimbursement rates. This program will focus on best episode management and process improvement practices including the referral, intake, and scheduling processes, timely documentation, and physician and patient communication strategies — all of which are required to more tightly manage care within the 30-day payment period.

Attendees receive 1.5 continuing education units per webinar (6.0 for the full series) for skilled nursing, occupational therapy, and speech therapy per webinar.

Part 4: Medicare Advantage & Medicare Secondary Payer

The fourth and final part of this four-part series covers the following topics:

• The credentialing process with Medicare Advantage (MA) plans
• The most important questions to ask before signing an in-network agreement
• The impact of MA plans on the Medicare program
• The most common claim denial reasons and how to work through them
• The most common roadblocks in getting MA plans to appropriately process and pay claims
• Details of Medicare Secondary Payer (MSP)
• Best practices for determining when MSP applies

Series Schedule

Each of the webinars in the series will be held on Tuesdays at 10:00-11:30 AM ET on the following dates:

• December 13, 2022 – Part 1: PDGM Model Review & Impact on Billing
• December 20, 2022 – Part 2: Submission of the NOA & Specifics of Billing 30-Day Final Claims
• January 10, 2023 – Part 3: PEPPER Reports & Best Practices for Implementing the Results
• January 17, 2023 – Part 4: Medicare Advantage & Medicare Secondary Payer

If you register for the whole series but miss a program, don't worry. The recordings of all sessions will be available on our online training hub at HomeCareLearn.com.

Meet the Speaker

Melinda A. Gaboury, COS-C, is Co-Founder/Chief Executive Officer of Healthcare Provider Solutions. 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, and TPE appeals with all Medicare MACs have become the forefront of Melinda’s current impact on the industry. Melinda is currently serving on the NAHC/HHFMA Advisory Board and Work Group, as Treasurer of the Home Care Association of Florida Board of Directors, and was named to the Tennessee Association for Home Care Board of Directors in 2022. Melinda is also the author of the Home Health OASIS Guide to OASIS-E and Home Health Billing Answers, 2023.

Registration & Fees

Register online or call (850) 222-8967 to register by phone. HCAF members receive a registration discount! To receive the discount, please log in to your profile before registering. Registration fees for this program are as follows:

An additional registration fee will be charged for each additional login. Participants are encouraged to log in at least 15 minutes before the webinar begins. By registering for this event, you are agreeing to our payments, cancellation, and substitution policies. 

Sponsors Welcome

HCAF offers a multitude of ways for home care industry vendors to promote their products and services throughout this series across the state, including in-person and virtual sponsorship opportunities. For more information about sponsoring this webinar program or the full webinar series, please contact us.