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Executives from Concierge Homecare, Gaffey Nursing Services, HealthRev Partners and Forcura explored how home health agencies who modified processes to be compliant with Review Choice Demonstration also benefitted operationally, financially and clinically across all their service lines. Course Instructor: Kim Gaffey, Linda Murphy, Stephanie Henchey, Michelle Mullins, Kate Warnock Read more

With the Patient-Driven Groupings Model (PDGM), your charts are subject to increased scrutiny as it relates to accurate coding and medical necessity. Is your coding as accurate as it needs to be? In this intermediate-level ICD-10 coding workshop, we will work common home health scenarios, discuss guidance and conventions for accurate coding, and review new Medicare guidelines and OASIS updates.  This two-day, interactive workshop will enable your agency to thrive in the new world of the PDGM, as well as the Review Choice Demonstration (RCD).  Attendees will need the 2022 ICD-10 coding manual. Course Instructor - Apryl Swafford, RN, BSN, COS-C, HCS-D, HCS-H Read more

This session focuses on the need for a streamlined referral process, which ensures that patients are admitted promptly and that providers receive adequate reimbursement for the services provided. We will focus on securing all the necessary documentation to be compliant, including the pre-claim review documents required for the Medicare Review Choice Demonstration (RCD).  Read more

"The Centers for Medicare & Medicaid Services (CMS) has fully resumed all medical review activities. Getting selected for an audit has significant ramifications, including the need to devote resources to responding to and dealing with the results. Post-payment reviews, such as Unified Program Integrity Contractor (UPIC) audits, can put $100,000 on the line, potentially reaching into the millions. Providers must be aware of risk factors and trends in agency documentation that may prompt review or denial. It is crucial to reduce risk continuously and respond assertively to reviews. The Medicare Review Choice Demonstration (RCD) does not protect agencies from UPIC activity, and audits clearly show the provisional nature of pre-claim review affirmations. With numerous reviews of medical records and multiple contractor audits, prevention is the best course of action. In the face of financial disruptions resulting from a review, prompt positive actions and knowing your options are key to keeping your agency solvent. This presentation is based on 25 years of experience assisting agencies with medical reviews, as well as current UPIC audit trends."   Read more

Palmetto GBA's Charles Canaan and Michael Bibbins will reveal the mysteries of the Centers for Medicare & Medicaid Services (CMS) Review Choice Demonstration (RCD) during this workshop. They will shine light into dark corners you may not have looked at before. This includes recent RCD changes, trending topics, top denials, and selection statistics. Additionally, the speakers will share critical clues and tips about the recent changes in billing requirements that providers need to watch out for, such as new telehealth G codes and Notice of Admission (NOA) requirements. They will explore trending topics and dive deep into the scenarios that spur investigations and calls from providers, and generate education sessions. The top denials portion of the program will unveil the top Additional Documentation Request (ADR) denial reasons as well as the top non-affirmation reasons. Finally, the speakers will discuss Florida selection data and trends without too much foreshadowing. Establish your alibi by attending this workshop and don’t miss this opportunity to get in-person feedback about your RCD mysteries. Read more

Join Palmetto GBA representatives for a presentation on several key areas of the Medicare Review Choice Demonstration (RCD) program that providers will face. The speakers will cover RCD basics, tips for navigating each selection, and review the frequently asked questions from home care providers. The pair will also tackle common issues and take your questions. Read more

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