Home Health Billing Webinar Series: Part 3 of 4 Sessions

The first part of this four-part series covers the following topics:

• Key revenue cycle operations affected by the PDGM
• Necessary modifications to the intake and referral process under the PDGM
• Data to assist in determining the financial impacts of the PDGM on a home health agency
• Specificity requirements of coding under the PDGM
• Strategies for improved physician interaction to ensure timely 30-day billing
• The importance of clinical review of each 30-day payment period under the PDGM

The second part of this four-part series covers the following topics:

• Detail requirements for submitting the Notice of Admission (NOA)
• Scheduling strategies to prevent penalties for late NOAs
• NOA exceptions request process
• Requirements for submitting final claims
• Complexities of determining Low Utilization Payment Adjustment (LUPA) thresholds under the PDGM
• Reconciliation process after posting payments for claims

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The third part of this four-part series covers the following topics:

• The Payment Patterns Electronic Report (PEPPER) and how it relates to 30-day final claims
• Specific targets and data behind the calculation
• PEPPER scores and comparisons to national statistics
• PEPPER data effect on medical review
• Process for providers to evaluate data and implement a plan of correction if needed

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

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