Home Health Medicare PPS Billing Workshop

Home Health Medicare PPS Billing Workshop

Click to Register Baton Rouge 4/27/10

Event Location:

Embassy Suites
4914 Constitution Avenue
Baton Rouge, LA 70808
Phone: 225-924-6566

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Click to Register for Monroe 4/28/10

Event Location:

Hilton Garden Inn
400
Mane Street
West Monroe, LA 71291
Phone: 318-398-0653


$195.00 $375.00
Event Starts: 8:00am (GMT-06:00) Central Time (US & Canada)
Event Ends: 5:00pm (GMT-06:00) Central Time (US & Canada)
Event Details Click here to view brochure

Speaker Information:

Melinda Gaboury is co-founder and Chief Executive Officer of Healthcare Provider Solutions, Inc. (HPS).  Prior to the inception of Medicare PPS Gaboury began researching, auditing and review processes with OASIS, ICD-9 Coding and clinical documentation. She has developed and taught clinician and billing Medicare PPS Training Workshops in a variety of venues.  Gaboury’s priority remains bridging the gap between clinical and financial issues in home health agencies.   The one unique thing that Gaboury brings to the home health field is the development of very effective OASIS and Billing Education while being able to also teach the reimbursement aspect and how they are directly related.

Workshop Information:

Billing is a very critical part of home health. This workshop will lay a concrete foundation for new billers, as well as, experienced billers by giving billers a more effective approach to the Medicare PPS regulation, conducting Medicare verifications and understanding adjustments. We will discuss Medicare verifications on patients with HIQH screen examples & review adjacent episode calculations – field by field on claim forms. We will review the process of auditing a pre-bill for final claim purposes, both Medicare and Non-Medicare Payers, and review the details of billing for Non-Routine Supplies using list and billing guidelines. Direct Data Entry Screens will also be reviewed.

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House Passes on Healthcare Reform

On Sunday, March 21st the US House of Representatives passed historic Health Care Reform Legislation. A friend from Maryland shared the following information related to the House of Representatives’ latest adaptations (that impact home health gathered from a phone conference with Bill Dombi of NAHC. These are changes the House is putting into the Senate bill. Please note that the remainder of the Senate bill is unchanged, including Medicare HH cuts, hospice cuts, Medicaid home care improvements, and the CLASS Act.

These changes include additional cuts to hospitals, Medicare advantage, DME, outpatient services, and imaging services. There are no increased cuts to home health or hospice.

The Senate bill has far less cuts than the House bill. Also the cuts that are in the Bill will come in much later than the original House version or that of the Obama administration, giving time for agencies to adapt or home health advocates time to repeal or change the legislation. There would be no cuts in the 2010 home care payment rates. There may also be a rural add-on of 3% April 1, 2010. Also included:

1. The Nebraska “special deal” is out.

2. Chronic Care Management is still in. (That may have a bright future.)

3. Emphasis on fraud and abuse is still in

4. Super MedPAC is still in. However, more powers are being reserved for Congress.

5. Post Acute bundling is still in as a pilot project.

At last count 204 Democrats will vote yes. 12 more are needed. The latest estimate is that there is a 49% to 50% chance the bill will pass.

The 36 month Rule- If a home care agency has enrolled in Medicare or changed 5% of their ownership in the last 36 months, they will lose their ability to bill Medicare if they change their ownership again. If a deal was done and a Form 855 was properly filed before January 1, 2010, the agency is exempted from this rule.

If any home health agency has had ANY improper coverage determinations recently– homebound,etc. please contact HCLA immediately. The national association is forming a group appeal.

The MedPAC Report to Congress (Available at MedPAC.gov.) Bill Dombi indicates this shows why MedPAC is hostile to home care. The report speaks of alleged therapy misuse, continues to speak of case mix creep, a rapid increase in the number of agencies, and more. MedPAC recommended co-pays for home care. That is not likely to happen in 2010. However, they will keep proposing it in 2011 and beyond. Every agency needs to stay involved politically. There are major threats and opportunities that are constantly facing us.

Who will be the first Louisiana agency to sign on to visit Washington, DC this April 12th and 13th? As of Friday morning, March 19, 2010, I have gotten no response to the request to have someone join HCLA on Capitol Hill. I’ll be reporting the numbers I get every few days until April 9th. Would you please join HCLA’s contingent on Capitol Hill on Lobby Day?

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Save the date – November 2 – 3, 2010

2010 HCLA/LALA Annual Conference
Baton Rouge, LA
November 2 – 3, 2010

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