Description
More than 75% of agencies under the Review Choice Demonstration choose Pre Claim Review (PCR). Medical necessity was one of those things that we never really had to think much about under PCR. It was the one thing that Palmetto wasn’t focused on during their reviews…Well…now that RCD has been extended another 5 years, there is a renewed focus on the it by Palmetto. So, are your PCR submissions ready for the increased scrutiny? This session will cover the basics of Medical Necessity under the Medicare benefit and we will learn what Palmetto is looking for and how to provide the information needed to get those quick affirmations. All this while using what you already have in your charts and without spending more time on the overall process. Discussion will include the “ new” wound care and Hand-Off requirements. Medical necessity…it’s baaack!
Speakers/Course Authors - Kim Wilkerson
Objectives
Course Objectives:
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Learner will be able to identify and understand pertinent statutes regarding Medicare coverage for Home Health Services
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Learner will be able to articulate the various components of the a skillable episode of care
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Learner will be able to describe and be able to successfully document medically necessary skill to satisfy PGBA PCR reviews
Certificate
By completing/passing this course, you will attain the certificate HCAF Course Certificate
Learning credits
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