Hospice Eligibility and Certification - The Continuing Saga
It is critical that hospices understand the regulatory requirements of certification and recertification and to have a process that ensures doing it right the first time!!
Hospices are undergoing increased regulatory scrutiny from CMS through Medicare Administrative Contractors (MACs), the OIG, Zone Program Integrity Contractors (ZPICs) and eventually Recovery Audit Contractors (RACs). Certifications are a condition of payment. It is critical that hospices understand the regulatory requirements of certification and recertification and to have a process that ensures doing it right the first time. There is no room for error.
Join Charlene Ross for this 1-hour session where she will explore the regulatory requirements related to the certification and recertification process including the face-to-face encounter requirement. Also Ross will explore what types of documentation of eligibility is required for the certification and recertification process. This audio session will include the examples of supporting clinical documentation that should be present at certification and / or recertification.
- Understand the regulatory requirements of certification, recertification and eligibility
- Understand the purpose and intent of the Medicare regulations related to certification, recertification and eligibility
- Identify and debunk myths surrounding the regulations
- Establish a framework to ensure the certification / recertification process is solid
- Identify a process for ongoing monitoring of the elements of certification / recertification for each patient
- Discuss about the requirements for auditing a Compliance Program
- Recognize appropriate documentation that supports eligibility at initial certification and recertification and that also supports medical eligibility.
- Utilize outside clinical supporting documentation to support eligibility
- Discuss the use of the LCDs in the certification and recertification process
- Integrate the use of Palliative Performance Scale (PPS), New York Heart Classification, Functional Assessment Staging (FAST), Body Mass Index (BMI), and other objective data in supporting eligibility
Who should attend? Intake staff, Administrators, Quality managers, Admitting nurses, Clinical staff
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About Our Speaker
Charlene Ross after receiving an MSN from the University of Texas Health Science Center in San Antonio, Texas, and an MBA from the University of Incarnate Word in San Antonio, Texas, Charlene Ross began her career in leadership as a nurse manager; however, her ability to analyze problems, develop and simplify procedures, and find innovative solutions rapidly moved her to the forefront of improving operations for...
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- Save money on travel.
- Meet your specific training needs.
- Keep learning after the event.
- Save time training your whole staff.