While leadership and management deal with results of target audit probes such as Centers for Medicare & Medicaid Services (CMS) probes, ZPIC/UPIC (Zone Program Integrity Contractor/Unified Program Integrity Contractor) audits, and Recovery Audit Contractor (RAC) reviews, the battle for agency reimbursement is won or lost. "If it wasn't charted, it wasn't done" is the old adage, but "If it was charted wrong, it won't be paid" is the new version in the Medical Review world of home health. This presentation combines 11 key Medicare rules and regulations your staff need to know, need to document, and need to follow so that any medical review does not take back the visits and cause financial hardships for your agency. Even experienced staff need to have a clear and present knowledge and integrate these requirements into their charting. How these requirements or lack of these show up in denial explanation letters is also used to demonstrate the importance of charting these right the first time. Addressing these as part of agency culture is an investment in prevention.
Course Authors: Laura Page-Greifinger
- Attendees will express an understanding of the revised Conditions of Participation and their impact on a clinician's delivery care in a compliant manner.
- Attendees will express an understanding of the regulations specifically related to patient eligibility, documentation and the delivery of skilled, reasonable and necessary care.
- Attendees will express an understanding of the top reasons why home care services are denied coverage.
By completing/passing this course, you will attain the certificate HCAF Course Certificate
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