Effective Documentation to Ensure Compliance with F2F and Other Home Health Certification Requirements

Event Information
Product Format
Prerecorded Event
Presenter(s)
Judy Adams, RN, BSN, HCS-D, AHIMA approved ICD-10-CM Trainer
Length
90 minutes
Product Description

Latest Guidance for Face to Face and Home Health Certification Documentation


Face to Face (F2F) documentation has been an exceptional burden for home health agencies (HHAs) ever since its inception. With constant changes in interpretation and documentation expectations, the denial rate based on inadequate or insufficient F2F documentation continues to average 59% of claims reviewed. Further, increased focus on documentation of home health certification and re-certifications in the last few years has added to the burden of denials for home health agencies.

That is especially true when home health agencies are confronted with Additional Documentation Requests (ADRs) related to Phase 2 of Probe and Educate or any medical review request. Under the Probe and Educate program mandate, there is no limit to the length of time an HHA can be subject to these reviews if greater than one denial is received in the claim sample. HHAs must be prepared to proactively avoid claim denials through effective, compliant documentation.

In this informative session, Judy Adams will assist HHAs in avoiding denials and receiving the reimbursement they are due for their claims.

Session Highlights

  • Identify the requirements for certification and re-certification of home health episodes
  • Understand the focus and documentation requirements for Phase 2 of Probe and Educate which is being implemented nationwide
  • Understand the process under Pre-Claim Determination that is being activated again for additional states along with strategies to successfully meet the challenges of these two programs
  • Overview of Phase 2 of the federal government’s Probe and Educate Audits
  • Overview and discussion of the Pre-Claim Determination Project
  • CMS guidance to contractors on home health pre- and post-claim reviews with specific information on the requirements for certification and re-certification documentation
  • Current Face-to-Face requirements with samples of acceptable documentation and proactive strategies by the HHA to ensure the F2F documentation is acceptable to successfully meet the requirements that involve all members of the home health team
  • Resources available to home health agencies including frequently asked questions, Medicare guidance and appeal options if claims are denied

Session Snapshots

  • Face to Face and current regulations
  • Documenting when an acute/post-acute physician certifies a patient
  • Case studies
  • Meeting F2F requirements
  • Unacceptable F2F documentation
  • New F2F updates and required
  • F2F recommendations and strategies for compliance
  • Probe and education reviews
  • 5 certification requirements
  • Preparation for audits
  • Additional HHA actions

Why Attend?

Everyone involved in home health must be knowledgeable about the Probe and Educate and Pre-Claim Demonstration Projects and work together to ensure home health documentation is meeting the requirements so claims are paid on first submission. Survival of the health agency is dependent on submitting compliant claims and documentation to support the provision of documentation that supports both eligibility and coverage criteria.

Who should attend?

Home health staff with administrative, supervisory, quality improvement and compliance responsibilities plus clinical visiting staff and billing staff.

Order Below or Call 1-866-458-2965 Today

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1-866-458-2965

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About Our Speaker

Judy Adams - Home Health Coding Expert

Judy Adams, RN, BSN, HCS-D, HCS-O, has been involved in health care in numerous health care setting over the span of her career. She has been involved in nearly every aspect of home health care over the last three decades including direct clinical care, supervision, administration and quality improvement.


In 2009, she opened her own education and consultation company with a primary focus on...   More Info
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