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Now that the Medicare Review Choice Demonstration (RCD) phased-in approach has begun, some Florida home health care providers are participating in the pre-claim review (PCR) process. In fact, during last month's RCD webinar 72.44% of attendees stated they planned to gradually increase the claims they submit in order to achieve 100% compliance within the 60 days following the August 31, 2020 start date. As a result, HCAF has planned to host monthly check-up webinars where Florida home health providers can check in and learn about how things are going for those who started the process. Attendees will also hear from industry expert Melinda Gaboury, CEO of Healthcare Provider Solutions, who will provide you with food for thought on key things to consider throughout the RCD implementation process. Whether you have started the process or are waiting to start until it becomes absolutely necessary, now is the time to come together to learn about how to achieve success in this demonstration while minimizing missteps. Course Instructor - Melinda Gaboury Read More

Florida home health care providers received some welcomed news last week when the Centers for Medicare & Medicaid Services (CMS) announced a delayed phase-in of the Review Choice Demonstration (RCD). Providers were told they may participate in the pre-claim review (PCR) process beginning on August 31, but are are not required to do so. While this is great news, it also left many of you with unanswered questions such as: Should we begin submitting claims for the PCR process?Should we wait until we are required to submit? If we start submitting on August 31, can we only submit a few claims to test the system and our processes? Are all my claims going to require a Unique Tracking Number (UTN) if I start submitting claims on August 31? If I chose not to submit now, will my claims be subject to 100% post-payment review? If I choose not to submit now, will my claims be subject to the 25% payment reduction? With these questions and so many more on the mind of providers, HCAF is hosting a webinar with industry expert Melinda Gaboury of Healthcare Provider Solutions, who will provide you with the answers to these questions and many more! Course Instructor - Melinda Gaboury Read More

This webinar is being planned in order to give practical, real-life help to home care agencies tackle the RCD hurdle. This will not just be a high-level review of RCD. Instead, we will take a deep dive into the common problem areas associated with RCD in the states that have already implemented the RCD demo. Please join us safely online to learn how to decrease the hazards of non-affirmation and claim denials. Speaker DeAnn Briscoe, BSN, RN, COS-C will explore common areas which trigger non-affirmations or claim denials in the RCD process. She will also share strategies from Texas, Ohio and Illinois to increase your success in the medical review process of RCD. Of course, it will be a wonderful scenario if RCD is further delayed until the current public health emergency is behind us, but we cannot assume that will happen! The time to prepare is unfortunately now! Speakers/Course Authors - DeAnn Briscoe BSN, RN, COS-C  Read More

The Medicare Review Choice Demonstration (RCD) begins in Florida on August 31, 2020, coinciding with the novel coronavirus (COVID-19) outbreak and the new Patient-Driven Groupings Model (PDGM) payment overhaul. Prepare now for RCD success with a webinar presentation by Palmetto GBA for home health providers that will review the basics of this five-state demonstration. This presentation will demonstrate how providers can select the review choice option through Palmetto GBA's online eServices portal during the two week window, August 3 through August 17. Additionally, lessons learned from the RCD in Illinois, Ohio, and Texas will be examined. Don't miss this opportunity to hear directly from your Medicare Administrative Contractor and get answers to your questions before the August 31 implementation.    Speakers/Course Authors - Cara Mia Wilkins & Elizabeth Brogdon    Read More

While 2020 began with the change to the Patient-Driven Groupings Model (PDGM) for reimbursement taking up home health agencies’ attention, the expansion of Review Choice Demonstration (RCD) was soon to follow. Both of these have been affected by the onset of the Covid-19 pandemic and resulting Public Health Emergency (PHE). At some point the PHE will expire, followed by a resumption of medical review activities by Medicare contractors. Medicare contractors normally use Targeted Probe and Educate (TPE), Unified Program Integrity Contractor (UPIC), Recovery Audit Contractor (RAC), and Supplemental Medical Review Contractor (SMRC) reviews to evaluate claims for coverage and payment. How the PDGM provides payment will also have a significant impact on review results. This presentation will walk attendees through the PDGM payment model and how it affects medical reviews and denials. The impact of RCD activity on medical reviews is significant, both for agencies who choose a Pre-Claim Review option or an Additional Development Review (ADR) choice. This presentation will focus on agency actions to lower risks of being chosen for medical review and high-risk areas for denials. The status of the RCD and preparation tasks for when the RCD is started will be addressed. Finally, the PHE changes are also covered with suggestions for compliant documentation during the PHE to prevent problems after the PHE has ended. This program benefits home health agency Administrators/Managers, Clinical Supervisors/Managers, Directors of Nursing, and QA/QI staff. Course Instructor - Joe Osentoski Read More

The Medicare Review Choice Demonstration (RCD) begins in Florida on May 4, 2020, coinciding with the novel coronavirus (COVID-19) outbreak and the new Patient-Driven Groupings Model (PDGM) payment overhaul. Prepare now for RCD success with a webinar presentation by Palmetto GBA for home health providers that will review the basics of this five-state demonstration. This presentation will demonstrate how providers can select the review choice option through Palmetto GBA's online eServices portal during the 30-day window, March 20 through April 19. Additionally, lessons learned from the RCD in Illinois, Ohio, and Texas will be examined. Don't miss this opportunity to hear directly from your Medicare Administrative Contractor and get answers to your questions before the May 4th implementation.  Course Author: Cara Mia Wilkins, Charles Canaan, Dan George, Elizabeth Brogdon  Read More

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