Part 1 – Eligibility Requirements & Notice of Election
Hospice billing staff are extremely valuable in the assurance that you are maximizing reimbursement in the most timely manner. Medicare billing regulations can be overwhelming and clarifications are continuous. Hospice Reimbursement is driven by excellent care and documentation and a billing staff that can bring it home.
This three-part series will establish and/or cement the foundation for hospice staff that need to have a full understanding of Medicare regulations. Medicare eligibility verifications, field-by-field detail on Notice of Election and claim forms, and changes to the billing requirements will be covered. This series will review regulations for billing all hospice services, face-to-face encounters, and home health providing care while a patient is on service with hospice. Hospice information including the aggregate cap self-report, palliative care billing basics, and the latest on HIS updates and transmission requirements will be emphasized. If you are part of hospice revenue-cycle team, this webinar series is a must!
The 2020 Hospice Rule brought some significant changes in reimbursement as well as the content of the actual Election Statement and future Addendum. New and experienced hospice billers periodically need a review of eligibility requirements. Eligibility and requirements for Notice of Election will be detailed during this webinar. The updates to being able to correct a Notice of Election that was not filed, within the allowable time, will be reviewed. This session will walk through the Late Notice of Election and the exceptions process of appeal. A comprehensive review of all eligibility requirements, all aspects of dealing with Election statement changes and all things related to the Notice of Election will be included.
Part 2 – Details of Medicare Claims Processing
Accurate monthly claims and understanding of the navigation surrounding the edits and errors is key to getting paid correctly and timely. This session will take billers through the step by step process of monthly Hospice billing and providing examples of how hospices have successfully dealt with recent changes. The most recent of reimbursement changes will be addressed including proposed changes to the base rates for Hospice levels of care through rebasing. This session will also provide a step by step through the content of the final claims and frequent billing issues. Physician billing will be covered in this session.
Part 3 – Face-to-Face, Hospice Cap, HIS & Top 5 Denial Reasons
All of the nuts and bolts that hold Hospice reimbursement together will be covered in this webinar. Face-to-Face requirements, physician billing, and the aggregate cap self-reporting requirement are a few among many of the daily reimbursement related challenges. A review of specific HIS reporting requirements will be addressed to expand your agency's knowledge of Hospice reimbursement related components. Lastly, the top 5 denials reasons for denied claims under medical review will take agencies a step beyond the basics of just getting a claim processed for payment.
About the Presenter
Melinda Gaboury, is co-founder and Chief Executive Officer of Healthcare Provider Solutions, Inc., an organization out of Nashville, TN that provides financial, reimbursement, clinical and operation services to the home health and hospice industries. With more than 27 years of experience in Medicare Home Health, she is a presenter at both the state and national levels, and is interviewed frequently for national home health publications. Ms. Gaboury is also the author of "Home Health Guide to OASIS D: A Reference for Field Staff." Ms. Gaboury has no conflict of interest in regard to this program.
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The Ohio Council for Home Care & Hospice is an approved provider of continuing education by the Ohio Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. (OBN-001-91))
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