Demonstrations by CMS are not new to homecare. What is New is an entire review of your claims before submission of those claims. While CMS claims this is a way to ‘prevent fraud’, the results of this egregious rule is causing absolute chaos in those States affected. This is reported to be a 3 year demonstration in 5 States, but it is already causing a path of undue hardship in Illinois.
However, CMS is not budging. To date, there are few claims getting through the Pre-Claim Review process with “non-affirmations”. CMS is quick to point out that these non-affirmations are not ‘denials’, but simply letting you know the claim will not be paid. The entire industry needs to understand this process. This could very well become the payment future for home health care in all states. There has never been a more incredible reimbursement change since the imposition of IPS in the late 1990’s. This rule has the potential of closing more than 50% of agencies in the demonstration States.
Join this session by expert speaker Arlene Maxim to get tips for clearing the PCR process. The session will also provide you a copy of one MAC’s work flow with advice on submission. Given the impact and importance of this new rule, no homecare owner or manager should miss the opportunity to learn about it. This webinar will provide the most up-to-date information from Agencies in Illinois on just how they are handling the CMS Pre-Claim Review rule.
Arlene will also discuss:
Who Should Attend
- Apryl Swafford
Arlene Maxim currently holds the position of Vice President of Program Development for Quality in Real Time (QIRT) based in Floral Park, New York. She has been in home care since 1979 and has been a home health care consultant since 1986. Drawing on her strong clinical background, she has served in various capacities from home care administrator to home care agency owner and home care consultant. She...
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