UPDATES ON HOME HEALTH PROBE AND EDUCATE AUDITS AN 2016 - Navigating Through the Home Health Probe and Educate Audits Relating to Verifying Compliance with Certification and Recertification Requirements - By Compliance Global Inc

Website https://complianceglobal.us/product/700506/JudyAdams/home-health-probe-and-educate-audits-relating-t | Edit Freely

Category Health, Clinicians

Deadline: August 24, 2016 | Date: August 24, 2016

Venue/Country: Online Training, U.S.A

Updated: 2016-07-22 18:13:30 (GMT+9)

Call For Papers - CFP

CMS implemented the home health Probe and Educate Project in January 2016 to determine how well home health agencies are complying with the certification and recertification requirements under the Medicare home health care benefit.

The project requires that every one of the more than 6,000 certified home health agencies have an audit of a sample of five (5) pre-payment home health episodes. Agencies that receive denials on 2 or more of the sample records are subject to a second review of five more claims and the process can repeat as long as the agency has more than one record denied. The greatest fear is whether an agency can sustain the financial losses through repetitive cycles of these audits. The initial audits yielded denial rates as high as 97% of all claims reviewed.

This webinar will provide updates on the current experience with these audits and strategies to significantly improve your changes to meet the required threshold.

Why Should You Attend:

Knowledge is power and the more home health agencies are prepared for these audits, the greater likelihood that your agency will be able to survive the audit and be able to continue to provide services to the vulnerable populations that require home health services.

Avoid the uncertainty and fear of the Probe and Educate Audit experience by ensuring your agency is fully knowledgeable of the process for the audits and a complete understanding of all of the regulatory requirements for certification and recertification of home health episodes.

Probe and Educate Audits are full audits reviewing the entire medical record for the selected episodesto determine if they support all of the regulatory requirements for certification and recertification plus the medical necessity of all services provided during the claim period under review.

There is no limit to the number of cycles an agency can be subject to. Due to the significant financial losses if claims are denied, every Medicare home health benefit must proactively implement adequate documentation to support the care provided.

Areas Covered in this Webinar:

Process and guidelines for the audits

Current denial statistics and common deficiencies identified

Detailed information required for all five aspects of certification including:

Qualifying services for home health

Confined to the home/homebound status

A plan of care has been established and periodically reviewed by a physician

Services are furnished while the patient is under the care of a physician

Face to face encounter

Details related to meeting recertification requirements

Tips and Hints to meet requirements

Follow-up after the survey

5 stages of the appeal process

Learning Objectives:

Describe the process for Probe and Educate Audits

Identify the requirements for the 5 requirements of HH Certification

Identify the 5 stages of Appeal

Who Will Benefit:

Home Health Supervisors

Managers

Quality Improvement Coordinators/ Directors

Compliance Staff

Clinicians

Nurses

Therapists

Home health

Management Team

For more information, please visit : https://complianceglobal.us/product/700506/JudyAdams/home-health-probe-and-educate-audits-relating-to-verifying-compliance/1

Email: supportcomplianceglobal.us

Toll Free: +1-844-746-4244

Tel: +1-516-900-5515

Email: supportcomplianceglobal.us

Toll Free: +1-844-746-4244

Tel: +1-516-900-5515

Level:

Intermediate

Speaker Profile:

Judy Adams’s experiences include working closely with regulators, third-party payers, occupational licensing boards and home care providers on numerous issues involving health and social supportive services in the home and community settings.

For the past 20+ years, she has provided a variety of operational and clinical consultative services to large and small home care and hospice organizations in several states in the eastern half of the United States and taught hundreds of teleconferences and day-long workshops ondiagnosis coding, OASIS, home health prospective payment system, coverage and documentation, and a variety of other clinical and regulatory home health and hospice topics for individual agencies, state associations and national organizations.

In addition, she regularly conducts record audits related to compliance with regulatory and third party payer guidelines for home health and hospice agencies as well as coding and OASIS accuracy reviews.

Judy earned her diploma in nursing from Norwalk Hospital School of Nursing and Bachelor’s Degree in Nursing from the University of North Carolina at Chapel Hill. She has been certified as a Homecare Coding Specialist – Diagnosis (HCS-D) since 2003 and a Home Care Clinical Specialist – OASIS (HCS-O) since March 2011 from the Board of Medical Specialty Coding and Compliance and became an AHIMA approved ICD-10-CM Trainer in June 2012.

She served as a member of the Home Care Expert Panel to the Board of Medical Specialty Coding and Compliance from 2008.-2014. She regularly contributes to articles in a number of national publications on coding, home health and hospice issues.