Hospice Audit Results and Suggested Ways to Avoid Denials

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

Look at Risk Areas Leading to Increased Audits & Get Tips to Proactively Avoid Denials

 

In today’s environment of oversight and audits, it is more important than ever that all hospice patient records include thorough and complete justification for the Medicare hospice benefit from day one through the day of death or discharge from the hospice program. This includes not only qualifying for the hospice benefit initially, but during changes in the level of care needed as the patient may need to use routine home care, general inpatient care, and/or respite care.

The variety of CMS contractors have all increased audit activity over the last year with an expected increase in audit activity in 2016.

In this audio session, with expert speaker Judy Adams, RN, BSN, HCS-D, AHIMA approved ICD-10-CM Trainer, you will review the most common current reasons for hospice denials on audit and suggestions on ways to avoid denials. One of the most important strategies for hospices to avoid denials and ensure that your hospice claim meets the requirements for hospice coverage under the Medicare hospice benefit is thorough documentation. We will explore hints and tips in this area as well as other suggestions during the session.

The sessions will highlight data from the largest MACs findings from audits over the past 6 months, as well as available resources tips for responding to Additional Documentation Requests. We will also look at the risk areas leading to increased audits and tips to proactively avoid denials. Lastly, this program will include a list of references and resources helpful in avoiding denials when your record gets selected.

Session Highlights:

  • Top 5-10 main reasons for hospice denials
  • Suggestions on ways to avoid these denials from the MACs
  • Proactive steps to prepare for audits and lessen the chance of a denial
  • Expanded section on documentation recommendations from the day of admission through the episode of care
  • Role of all of the hospice team members to ensure every hospice admission meets hospice criteria from day one throughout the episode of care
  • References and resources for avoiding denials when your record gets selected
  • OIG recommendations based on study
  • How to prevent Hospice claim denials related to continuous care hours

 Session Snapshots:

  • Introduction to CMS Audit activities
  • MIC - Newest Audit Group
  • CGS  Hospice Denial Reason Codes
  • CGS Hospice Denial Reason Codes
  • Hospice Denial Fact Sheets
  • PGBA Top Hospice Denial Reasons
  • Prevent Not Hospice Appropriate Denials
  • GIG Report on Inappropriate GIP
  • General CERT Hospice Tips
  • Preventing Denial of Continuous Care
  • Hospice Tip: Signatures for Face-to-Face
  • General Hospice Documentation Tips
  • Document to Support Hospice Services
  • Documentation to Support Level of  Care
  • Review Prior to Claim Submission

Who should attend?

Anyone within the hospice organization who is involved with determining appropriate hospice diagnoses and coding hospice claims will benefit from this session including:

  • Hospice Personnel
  • Administrators,
  • Quality Improvement Staff
  • Supervisors
  • Clinical Staff

 

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

Session Snapshots:

 

-        Introduction to CMS Audit activities

-        MIC - Newest Audit Group

-        CGS  Hospice Denial Reason Codes

-        CGS Hospice Denial Reason Codes

-        Hospice Denial Fact Sheets

-        PGBA Top Hospice Denial Reasons

-        Prevent Not Hospice Appropriate Denials

-        GIG Report on Inappropriate GIP

-        General CERT Hospice Tips

-        Preventing Denial of Continuous Care

-        Hospice Tip: Signatures for Face-to-Face

-        General Hospice Documentation Tips

-        Document to Support Hospice Services

-        Documentation to Support Level of  Care

-        Review Prior to Claim Submission

You can also order through:
Phone

1-866-458-2965

Fax

1-919-287-2643

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
More Events By The Speaker

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