Description
"Defensible documentation" refers to charting that can withstand scrutiny from various medical reviewers aiming to recoup payments for unnecessary or inappropriate care. In legal contexts, it provides clear evidence of the care provided, by whom, and when. Simply following an electronic medical record (EMR) template may not suffice.
This presentation starts by exploring key Medicare rules and regulations as they relate to National Government Services (NGS) Local Coverage Determinations (LCD) to support hospice documentation, terminal prognosis, and level of care. By linking actual requirements with common denial reasons, it demonstrates how proper documentation can prevent a negative outcome, such as denied payment. Key hospice charting timepoints, including Certification of Terminal Illness (CTI), face-to-face encounters (F2F), and interdisciplinary meetings (IDT/IDG), are covered, along with specific signs, symptoms, labs, assessments, and indicators necessary to support hospice coverage.
Speaker/Course Author - Joe Osentoski, BAS, RN, GERO-BC
Objectives
After participating in the session, attendees should be able to:
- Understand current Medicare medical review activity.
- Gain knowledge of key hospice Medicare Benefit Policy Manual and NGS coverage requirements.
- Identify common denial reasons issued by Medicare reviewers.
- Acquire knowledge of key charting items to be generated and reviewed and the staff education needed for successful implementation.
Certificate
By completing/passing this course, you will attain the certificate HCAF Course Certificate
Learning Credits
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