This 3-hour program is designed to facilitate the understanding of the various Medicare audits that home care agencies may be experiencing now and in the future, and how to prevent and appeal Medicare denials. These audits include Comprehensive Error Rate Testing (CERT), Zone Program Integrity Contractors (ZPIC) (formerly Program Safeguards Contractors), and Recovery Audit Contract (RAC) among others, which are performed to identify overpayments to agencies that result in denials and payment recoveries. Some agencies have also experienced recent audits from the Office of the Inspector General (OIG) for OASIS acceptance in the state repository as a condition for payment, making it critical that agencies prepare for these audits and learn how to appeal denials.
Course Instructor - Cheryl Leslie & Pamela Meliso, JD, MPH
The active participant will be able:
1. Understand all the Department of Health & Human Services audit types from CMS and OIG for Home Health Agencies and Hospices
2. Develop sound compliance programs to prevent denials with internal audit and monitoring to identify risk areas and implement corrective plans
3. Learn the basics of how to appeal Medicare denials and when to get help
By completing/passing this course, you will attain the certificate HCAF Course Certificate
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